| Identifying factors to minimize phlebotomy-induced blood loss in the pediatric intensive care unit. | |
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MedLine Citation:
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PMID: 21499175 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE:: Phlebotomy-induced blood loss in critically ill children is common, contributes to anemia, and may be avoidable. We aimed to identify factors associated with phlebotomy-induced blood loss. DESIGN:: Prospective observational study, single-center tertiary children's hospital. SETTING:: Pediatric intensive care unit. PATIENTS:: A total of 63 patients admitted to the pediatric intensive care unit for >48 hrs from 2004 to 2005. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Phlebotomy resulted in a mean blood volume loss of 2.5 ± 1.4 mL per draw, 7.1 ± 5.3 mL per day, and 34 ± 37 mL per pediatric intensive care unit stay, of which 1.4 ± 1.1 mL per draw, 3.8 ± 3.6 mL per day, and 23 ± 31 mL per pediatric intensive care unit stay were discarded as excess. This excess represents 210% ± 174% of the volume requested by the laboratory and a 110% overdraw. Blood drawn from central venous catheters had significantly greater overdraw volumes, 254% ± 112%, compared to those of arterial, 168% ± 44%, and peripheral intravenous catheters, 143% ± 39%, p < .001. Blood draws sent for one test had an associated overdraw of 278% ± 81%, compared to draws sent for two, 168% ± 48%, three 173% ± 4%, and four or greater tests 55% ± 5%, p < .001. Patients <10 kg had significantly greater mean volumes of blood loss/kg/day compared to patients >10 kg, p < .001. CONCLUSION:: Blood drawn in excess of phlebotomy requirements exceeds the blood volume loss drawn for phlebotomy by two fold. Using indwelling catheters for phlebotomy often requires a discard volume to be drawn before obtaining the laboratory sample. Consolidating phlebotomy tests and using a closed system may decrease the amount of blood overdrawn and minimize overall phlebotomy-induced blood loss. |
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Authors:
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Stacey L Valentine; Scot Bateman |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-4-14 |
Journal Detail:
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Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: - ISSN: 1529-7535 ISO Abbreviation: - Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-4-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Department of Medicine (SLV), Children's Hospital Boston, Boston, MA; and University of Massachusetts Medical Center (SB), Worcester, MA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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