Reducing blood transfusion requirements in preterm infants by a new device: a pilot study

Ballin, Ami; Livshiz, Victoria; Mimouni, Francis; Dollberg, Shaul; Kohelet, David; Oren, Assaf; Arbel, Eliana; Boaz, Mona; Tal, A.; Matas, Zipora; Mandel, Dror

doi:10.1111/j.1651-2227.2008.01082.x

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…In recent years, technological advances have led to an increasing range of analytes measurable using microsample point‐of‐care platforms. ‘In‐line’ umbilical arterial catheter devices are now available to perform blood gas, Hct and electrolyte analysis without removing any blood from the infants (Widness et al , ; Ballin et al , ). For laboratory‐based tests, the use of placental blood for routine admission tests (such as blood culture, haematological and biochemical baseline status), the introduction of neonatal sampling tubes with clearly marked minimum volumes, and the return to the infant of deadspace blood draws via arterial catheters have significant reduced iatrogenic blood loss (Carroll & Widness, ).…”

Section: Preventive Strategies For Anaemia Of Prematuritymentioning

confidence: 99%

Management of anaemia in pre‐term infants

Saito-Benz

Flanagan²,

Berry

2019

Br J Haematol

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Pre-term infants have one of the highest transfusion requirements within the hospital-setting. The vast majority of blood transfusions performed in Neonatal Intensive Care Units (NICUs) are for medically stable pre-term infants with anaemia of prematurity, with the aim of improving oxygen delivery to the vital organs during the crucial phase of growth and development. However, despite the frequency of transfusion in this population, the potential benefits and harms of 'top up' transfusion are not fully understood, leading to practice variation between clinicians, institutions and countries. Significant advances have been made in the prevention of anaemia of prematurity, with recent emphasis on optimising infants' circulatory volume at birth via placental transfusion and preserving infants' own blood volume through innovative minimal sampling techniques. More research is urgently needed to establish optimal transfusion thresholds for these high-risk pre-term infants, for whom benefits as well as adverse outcomes may have consequences that extend for decades throughout the recipients' life-course. In this review, we will discuss some of the consensus and controversies regarding optimal management of anaemia in pre-term infants and highlight potential areas for future research.

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Section: Preventive Strategies For Anaemia Of Prematuritymentioning

confidence: 99%

Management of anaemia in pre‐term infants

Saito-Benz

Flanagan²,

Berry

2019

Br J Haematol

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“…Only two studies observed a significant decrease in transfusion number in the intervention group (30, 33). One similar study in neonates observed a significantly lower transfusion volume when returning hemodiluted discarded blood with the ErythroSave device (ErythroSave, Tel Aviv, Israel) (a disposable sterile syringe which avoids the blood to cloth) (36).…”

Section: Resultsmentioning

confidence: 99%

“…Some studies reported other health-related outcomes and showed no increase in adverse events such as sepsis or mortality and similar or shorter lengths of ICU and hospital stay (29, 30, 32–34, 36, 41, 44, 48, 49, 57). We were unable to evaluate the effect of quality improvement interventions on costs or other outcomes in our analysis.…”

Section: Discussionmentioning

confidence: 99%

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

François

Charlier

Balandier

et al. 2022

Pediatric Critical Care Medicine

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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.

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“…This suggests that minimizing blood wasting should be an important intervention to introduce into clinical practice. Blood conservation devices can help to reduce the amount of blood wasted for line rinsing (21,(28)(29)(30)(31)(32)(33). Arterial closed blood sampling devices such as the Venous-Arterial blood Management Protection device can significantly lower the amount of blood volume discarded (28)(29)(30)34).…”

Section: Discussionmentioning

confidence: 99%

“…Arterial closed blood sampling devices such as the Venous-Arterial blood Management Protection device can significantly lower the amount of blood volume discarded (28–30, 34). Returning hemodiluted discarded blood with the ErythroSave device (a disposable sterile syringe that avoids the blood to cloth) has also been shown to significantly lower transfusion requirements in neonates (33). Small volume tubes, as used in our unit, and bedside point-of-care tests may reduce the blood volume required for testing, especially for coagulation testing that generally requires more blood volume than other tests (35).…”

Section: Discussionmentioning

confidence: 99%

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

François

Sauthier

Charlier

et al. 2022

Pediatric Critical Care Medicine

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Fifty percent of children are anemic after a critical illness. Iatrogenic blood testing may be a contributor to this problem. The objectives of this study were to describe blood sampling practice in a PICU, determine patient factors associated with increased sampling, and examine the association among blood sampling volume, anemia at PICU discharge, and change in hemoglobin from PICU entry to PICU discharge.

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Reducing blood transfusion requirements in preterm infants by a new device: a pilot study

Abstract: The use of ErythroSave for sampling blood significantly reduced blood transfusion requirements in premature infants compared to sampling by conventional syringes.

Cited by 6 publications

References 17 publications

Management of anaemia in pre‐term infants

Management of anaemia in pre‐term infants

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

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

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