2000, Number 1
Next >>
Med Crit 2000; 14 (1)
Blood lost because of diagnostic laboratory tests in patients of the intensive care unit in a Military Hospital
Kaneko WFJT, Reyes CEJ, Hernández MF
Language: Spanish
References: 14
Page: 5-11
PDF size: 171.98 Kb.
ABSTRACT
Objective: To evaluate the amount of blood drawn for diagnostic tests in critically ill patients.
Design: Prospective and observational study.
Setting: ICU of a Military Hospital in Mexico City.
Patients: A total of 186 patients were enrolled in this study.
Interventions: None.
Measurements and main results: A mean value of 45 mL a day was drawn, and the total volume drawn during their ICU stay was 180.2 mL of 79 patients who received transfusions had a decrease of hemoglobin from 11.4 ± 0.18 g/dL to 10.9 ± 0.13 g/dL (p ‹ 0.001). Patients who did no received transfusions had 12.3 ± 0.24 vs 11.4 ± 0.15 g/dL of hemoglobin (initial and final values, respectively); p ‹ 0.001. The cost of laboratory tests was near of (500 US dollars)/day.
Conclusion: ICU patients had large losses from phlebotomy and the cost of laboratory tests is expensive.
REFERENCES
Miller ES. Blood lost because of phlebotomy. N Engl J Med 1975;292:319.
Lewis LL, Harrintong GR, Stoltzfus DP. The effect of arterial lines on blood drawing practices and cost in intensive care units. Chest 1995;108:216-19.
Cook DJ. Physicians perceptions of laboratory costs in the intensive care unit. Clin Invest Med 1992;15:476-81.
Spiegel JS, Shapiro MF, Berman B et al. Changing physician test ordering in a university hospital: an intervention of physician participation, explicit criteria, and feedback. Arch Intern Med 1989;149:549-53.
Lanuza DM, Jennrich JA. The amount of blood drawn for diagnostic test in critically ill patients. Heart Lung 1976;5:933-38.
Smoller BR, Kruskall MS. Phflebotomy for diagnostic laboratory test in adults. N Engl J Med 1986; 314:1233-35.
Eyster E, Bernene J. Nosocomial anemia. JAMA 1973; 223:73-4.
Tarpey J, Lawler PG. Iatrogenic anemia? A survey of venesection in patients in the intensive therapy unit. Anesthesia 1990;45:396-98.
Dale J, Pruett S. Phlebotomy-a minimalist approach. May Clinic Proc 1993;68:249-53.
Griner FP, Glaser RJ. Misuse of laboratory tes and diagnostic procedures. N Engl J Med 1982;307:1336-39.
Henry ML, Garner WL, Fabri PJ. Iatrogenic anemia. Am J Surg 1986;151:362-63.
Heber PC, Wells G, Blajchman MA et al. A multicenter, randomized, controlled clinical trial of transfusion requeriments in critical care. N Engl J Med 1999;340:409-17.
Rochelle L, Boggs MS, Wooldrige KM. Procedimientos de la American Association of Critical Care Nurses, tercera edición, Editorial Médica Panamericana 1995.
Mitchell J, Silver DO, Yue-Han Li, Lisa A, Gragg MS, Jubran F, Stoller JK. Reduction of blood loss from diagnostic sampling in critically iII patients using a blood-conserving arterial line system. Chest 1993;104:1711-1715.