Impact of Blood Sampling on Anemia in the PICU: A Prospective Cohort Study

François, Tine; Sauthier, Michaël; Charlier, Julien; Dessureault, Jessica; Tucci, Marisa; Harrington, Karen; Ducharme‐Crevier, Laurence; Omar, Sally Al; Lacroix, Jacques; Pont‐Thibodeau, Geneviève Du

doi:10.1097/pcc.0000000000002947

Cited by 9 publications

(15 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…critical illness; however, there is strong evidence that it is often excessive and involves considerable waste (1,6). Although multiple strategies have been suggested to reduce unnecessary blood testing, their implementation in clinical settings remains extremely variable and limited.…”

Section: E45mentioning

confidence: 99%

“…Anemia affects 50% of critically ill patients (adults and children) at ICU discharge (1–6), of which 30% of ICU adults also have underlying iron deficiency (7). Although the long-term consequences of this complication are still unknown in children, adult data show that anemia can persist for many months after a critical illness and is associated with fatigue and lower quality of life (7–9).…”

mentioning

confidence: 99%

“…Iatrogenic blood loss from testing is a potentially important and modifiable contributor of ICU anemia and iron deficiency. Blood testing is essential for diagnosis and management of patients with critical illness; however, there is strong evidence that it is often excessive and involves considerable waste (1, 6). Although multiple strategies have been suggested to reduce unnecessary blood testing, their implementation in clinical settings remains extremely variable and limited.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

François

Charlier

Balandier

et al. 2022

Pediatric Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

Blood sampling is a recognized contributor to hospital-acquired anemia. We aimed to bundle all published neonatal, pediatric, and adult data regarding clinical interventions to reduce diagnostic blood loss.DATA SOURCES: Four electronic databases were searched for eligible studies from inception until May 2021.STUDY SELECTION: Two reviewers independently selected studies, using predefined criteria. DATA EXTRACTION:One author extracted data, including study design, population, period, intervention type and comparator, and outcome variables (diagnostic blood volume and frequency, anemia, and transfusion).DATA SYNTHESIS: Of 16,132 articles identified, we included 39 trials; 12 (31%) were randomized controlled trials. Among six types of interventions, 27 (69%) studies were conducted in adult patients, six (15%) in children, and six (15%) in neonates. Overall results were heterogeneous. Most studies targeted a transfusion reduction (n = 28; 72%), followed by reduced blood loss (n = 24; 62%) and test frequency (n = 15; 38%). Small volume blood tubes (n = 7) and blood conservation devices (n = 9) lead to a significant reduction of blood loss in adults (8/9) and less transfusion of adults (5/8) and neonates (1/1). Point-of-care testing (n = 6) effectively reduced blood loss (4/4) and transfusion (4/6) in neonates and adults. Bundles including staff education and protocols reduced blood test frequency and volume in adults (7/7) and children (5/5). CONCLUSIONS:Evidence on interventions to reduce diagnostic blood loss and associated complications is highly heterogeneous. Blood conservation devices and smaller tubes appear effective in adults, whereas point-of-care testing and bundled interventions including protocols and teaching seem promising in adults and children.

show abstract

Section: E45mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

François

Charlier

Balandier

et al. 2022

Pediatric Critical Care Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…Francois T, Sauthier M, Charlier J, et al: Impact of Blood Sampling on Anemia in the PICU: A Prospective Cohort Study (2).…”

Section: Do We Still Have a Problem With The Amount Of Blood Volume S...mentioning

confidence: 99%

“…Two problems in prior research are: 1) need to use some other prior probability, or case selection such as sepsis, and 2) sample size required for a validation study. Researchers have now combined a database from 33 PICUs in the United Kingdom and Republic of Ireland and 29 units in Australia and New Zealand and identified over 60,000 cases with Robert C. Tasker, MBBS, MD, FRCP [1][2][3] Editor's Choice Articles for June both base excess and lactate recorded (3). The article is worth reading because we now have an answer to the presenting biomarker-mortality relationship in the context of other available information used in the Paediatric Index of Mortality metric.…”

Section: Morris Kp Kapetanstrataki M Wilkins B Et Al: Lactate Base Ex...mentioning

confidence: 99%

Editor’s Choice Articles for June

Tasker

2022

Pediatric Critical Care Medicine

View full text Add to dashboard Cite

show abstract

Capnometry after an inspiratory breath hold, _PLATCO₂, as a surrogate for PaCO2 ${P}_{{\mathrm{aCO}}_{2}}$ in mild to moderate pediatric acute respiratory distress syndrome: A feasibility study

Cruces,

Moreno,

Reveco

et al. 2023

Pediatric Pulmonology

View full text Add to dashboard Cite

ObjectiveAccurate and reliable noninvasive methods to estimate gas exchange are necessary to guide clinical decisions to avoid frequent blood samples in children with pediatric acute respiratory distress syndrome (PARDS). We aimed to investigate the correlation and agreement between end‐tidal measured immediately after a 3‐s inspiratory‐hold (PLATCO2) by capnometry and measured by arterial blood gases (ABG) in PARDS.DesignProspective cohort study.SettingSeven‐bed Pediatric Intensive Care Unit, Hospital El Carmen de Maipú, Chile.PatientsThirteen mechanically ventilated patients aged ≤15 years old undergoing neuromuscular blockade as part of management for PARDS.InterventionsNone.Measurements and Main ResultsAll patients were in volume‐controlled ventilation mode. The regular end‐tidal (without the inspiratory hold) was registered immediately after the ABG sample. An inspiratory‐hold of 3 s was performed for lung mechanics measurements, recording in the breath following the inspiratory‐hold. (PLATCO2). End‐tidal alveolar dead space fraction (AVDSf) was calculated as and its surrogate (S)AVDSf as . Measurements of were considered the gold standard. We performed concordance correlation coefficient (ρc), Spearman's correlation (rho), and Bland–Altmann's analysis (mean difference ± SD [limits of agreement, LoA]). Eleven patients were included, with a median (interquartile range) age of 5 (2–11) months. Tidal volume was 5.8 (5.7–6.3) mL/kg, PEEP 8 (6–8), driving pressure 10 (8–11), and plateau pressure 17 (17–19) cm H2O. Forty‐one paired measurements were analyzed. was higher than (52 mmHg [48–54] vs. 42 mmHg [38–45], p < 0.01), and there were no significant differences with PLATCO2 (50 mmHg [46–55], p > 0.99). The concordance correlation coefficient and Spearman's correlation between and PLATCO2 were robust (ρc = 0.80 [95% confidence interval [CI]: 0.67–0.90]; and rho = 0.80, p < 0.001.), and for were weak and strong (ρc = 0.27 [95% CI: 0.15–0.38]; and rho = 0.63, p < 0.01). The bias between PLATCO2 and was −0.4 ± 3.5 mmHg (LoA −7.2 to 6.4), and between and was −8.5 ± 4.1 mmHg (LoA −16.6 to −0.5). The correlation between AVDSf and (S)AVDSf was moderate (rho = 0.55, p < 0.01), and the mean difference was −0.5 ± 5.6% (LoA −11.5 to 10.5).ConclusionThis pilot study showed the feasibility of measuring end‐tidal CO2 after a 3‐s end‐inspiratory breath hole in pediatric patients undergoing controlled ventilation for ARDS. Encouraging preliminary results warrant further study of this technique.

show abstract

Impact of Blood Sampling on Anemia in the PICU: A Prospective Cohort Study

Cited by 9 publications

References 49 publications

Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

Editor’s Choice Articles for June

Capnometry after an inspiratory breath hold, _PLATCO₂, as a surrogate for PaCO2 ${P}_{{\mathrm{aCO}}_{2}}$ in mild to moderate pediatric acute respiratory distress syndrome: A feasibility study

Contact Info

Product

Resources

About

Impact of Blood Sampling on Anemia in the PICU: A Prospective Cohort Study

Cited by 9 publications

References 49 publications

Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

Editor’s Choice Articles for June

Capnometry after an inspiratory breath hold, PLATCO2, as a surrogate for PaCO2 ${P}_{{\mathrm{aCO}}_{2}}$ in mild to moderate pediatric acute respiratory distress syndrome: A feasibility study

Contact Info

Product

Resources

About

Capnometry after an inspiratory breath hold, _PLATCO₂, as a surrogate for PaCO2 ${P}_{{\mathrm{aCO}}_{2}}$ in mild to moderate pediatric acute respiratory distress syndrome: A feasibility study