Diagnostic blood loss from phlebotomy and hospital acquired anemia in patients with severe burns

Yao, Ren-qi; Wu, Guosheng; Xu, Long; Ma, Bing; Ji, Lin; Shi, Lei; Tang, He-shan; Yao, Yong-ming; Xia, Zhaofan

doi:10.1016/j.burns.2019.08.020

Cited by 5 publications

(11 citation statements)

References 26 publications

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Section: Discussionmentioning

confidence: 99%

“…Some studies have found that some patients are more likely to suffer a decline in hemoglobin from blood collection, such as patients in ICU and pediatric department, patients with renal dysfunction, myocardial infarction, myasthenia gravis, blood purification, burns, or arteriovenous incision, etc. [14][15][16][17][18][19][20][21][22][23] Moreover, this decline in hemoglobin is significantly associated with prognosis. The reasons may be a large amount of blood collection, low blood volume, other overt blood loss, or hematopoietic insufficiency.…”

Section: Introductionmentioning

confidence: 99%

“…The first two are consistent with other studies that older age and more blood collection are associated with a higher risk of significant hemoglobin decline. 17,18,21,23,30 About the latter two, there has no relevant research before, which is an exciting aspect of this study. The result showed that the higher the hemoglobin value was at admission, the higher the risk of significant hemoglobin decline, and male had more risk than female.…”

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confidence: 99%

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Risk Factors Analysis for Hemoglobin Decline Caused by Diagnostic Blood Collection in Respiratory Department in North China: A Case-Control Study

Zhu,

Wang,

Han

et al. 2023

IJGM

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This study aimed to investigate the correlation between hemoglobin decline and diagnostic blood collection in the respiratory department and analyze the decline's risk factors. Patients and Methods: A case-control study in the respiratory department of a national tertiary hospital in north China, multivariable logistic regression analysis was used to find the risk factors. Patients excluding other factors affecting hemoglobin other than blood collection in the year 2021 were enrolled and divided into two groups according to the D-value of hemoglobin. The degree of hemoglobin decline caused by diagnostic blood collection between discharge and admission and its risk factors were analyzed. Results: Among the 530 patients screened in the study, ΔHb (the D-value of hemoglobin between discharge and admission) showed a skewed distribution with an average value of −4.38±0.514 g/L. We defined the D-value less than mean-2SD (ΔHb<-5.408) as a significant hemoglobin decline, by which the patients were categorized into two groups. Some variables had apparent differences between the two groups. By multivariable logistic regression analysis on these variables, the independent risk factors for significant hemoglobin decline (ΔHb<-5.408g/L) were revealed: age (OR=1.020, 95% CI 1.008-1.032, p=0.001), Male gender (OR=1.544, 95% CI 1.011-2.358, p=0.044), hemoglobin value at admission (OR=1.052, 95% CI 1.039-1.065, p<0.001), total blood collection volume (OR=1.021, 95% CI 1.010-1.032, p<0.001). Conclusion:In the respiratory department, older male and more diagnostic blood collection mean higher risks of significant hemoglobin decline. Surprisingly, the lower the hemoglobin value at admission, the lower the risk.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Risk Factors Analysis for Hemoglobin Decline Caused by Diagnostic Blood Collection in Respiratory Department in North China: A Case-Control Study

Zhu,

Wang,

Han

et al. 2023

IJGM

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“…The diagnostic blood loss was substantially lower in this study compared with a majority of previously reported studies quantifying daily and overall ICU admission phlebotomy blood loss (Table 5). [1,9,[18][19][20][21][22][23] Phlebotomy volume compared with the volume required to perform analyses showed that phlebotomy was almost always in excess of what was needed, the only exception being citrate tubes. It was notable that citrate tubes were frequently under-filled, giving a false impression of restrictive blood draws.…”

Section: Discussionmentioning

confidence: 99%

“…Other factors that contributed to under-reporting phlebotomyrelated blood loss in this study were the exclusion of phlebotomy for blood gas analyses, specimens for blood bank cross-matching purposes [1] 963 48.1 Holland et al 2020, United Kingdom [18] 40 60.0 Jackson Chornenki et al 2020, Canada [23] 7 273 25.0 Yao et al 2020, China [22] 157 6.8 Lyon et al 2013, Canada [21] 444 53.2 Tosiri et al 2010, Thailand [20] 44 9.8 Chant et al 2006, Canada [9] 155 13.3 Thavendiranathan et al 2005, Canada [19] 404 13.3 Vincent et al 2002, multicentre international [2] 1 136 41.1 for patients requiring blood or blood products, and phlebotomy for pharmacological analyses.…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

Iatrogenic blood loss in critical care: A prospective observational study conducted at Universitas Academic Hospital in the Free State Province, South Africa

Adams¹,

Barrett²,

Spruyt³

2022

South Afr J Crit Care

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Background. Prevention of iatrogenic blood loss is an essential component of patient blood management (PBM) in intensive care units (ICUs). The amount of iatrogenic blood loss from diagnostic phlebotomy in the ICUs at Universitas Academic Hospital, Free State Province, South Africa, is unknown.Objective. To quantify diagnostic phlebotomy volumes, and volumes submitted in excess for diagnostic testing in the ICU. Methods. We conducted a prospective descriptive observational study on adults who were admitted to ICUs at a single centre over a period of 14 days. The weight of each filled phlebotomy tube was calculated using the specific gravity of blood and averages of empty phlebotomy tubes, establishing the total volume.Results. Data from 59 participants with a median length of stay at the ICU of 3 days were analysed. The median phlebotomy volume was 7.0 mL day and 13.6 mL/ICU admission. The volume of blood required for analysis daily and ICU admission was 0.7 mL and 2.2 mL, respectively. The median phlebotomy volume in excess of the amount required for analysis daily and ICU admission was 5.05 mL and 12.11 mL, respectively. Conclusion. While the median excess daily phlebotomy volume in this present study may seem insignificant and underestimating the true excess of phlebotomy volume, interventions to reduce phlebotomy volumes and development of a PBM guideline for appropriate phlebotomy volumes and preventing wastage of patients’ blood in the ICU is required.

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Reducing Blood Loss in a Burn Care Unit: A Review of Its Key Determinants

Souto

Rodrigues

2022

Journal of Burn Care &Amp; Research

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Patients with a major burn injury differ considerably from the typical critical ill and trauma population. Very often, burn patients suffer from anemia throughout their hospital stay. This is caused both by combination of persistent blood loss with decreased erythropoiesis. Therefore, burn patients do have major transfusion requirements. However, transfusion is not devoid of risks or costs. We hereby review the best surgical techniques and medical approaches, aiming to reduce blood loss in a burn patient and optimize red cell production, so that we can reduce the need of RBC transfusion. The implementation of a combination of surgical techniques aiming to reduce blood loss and medical care approaches to prevent anemia, rather than single attitudes, should be adopted in burn care. There is an urgent need for clear guidelines that can easily be accepted, applied, and spread across different burn units to methodically implement measures to reduce blood loss and transfusion needs, and ultimately improve burn patients’ outcome and the health care financial status.

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Diagnostic blood loss from phlebotomy and hospital acquired anemia in patients with severe burns

Cited by 5 publications

References 26 publications

Risk Factors Analysis for Hemoglobin Decline Caused by Diagnostic Blood Collection in Respiratory Department in North China: A Case-Control Study

Risk Factors Analysis for Hemoglobin Decline Caused by Diagnostic Blood Collection in Respiratory Department in North China: A Case-Control Study

Iatrogenic blood loss in critical care: A prospective observational study conducted at Universitas Academic Hospital in the Free State Province, South Africa

Reducing Blood Loss in a Burn Care Unit: A Review of Its Key Determinants

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