Robert A Fowler1, Matthew Berenson. 1. Department of Medicine and Interdepartmental Division of Critical Care Medicine, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Abstract
OBJECTIVE: To describe blood conservation strategies for critically ill patients. DATA SOURCES: By using a predefined strategy, we searched the electronic databases of Medline, EMBASE, CINAHL, the Cochrane database of systematic reviews, Cochrane central register of controlled trials, ACP Journal Club, Database of abstracts of reviews and effects, and HealthSTAR for descriptions and evaluations of strategies of blood conservation among critically ill patients. DATA SUMMARY: A number of blood conservation strategies have been used to prevent or treat anemia among critically ill patients. These include restrictive diagnostic phlebotomy using small-volume or pediatric phlebotomy tubes, point-of-care and inline bedside microanalysis, minimization of diagnostic sample waste, minimization of routine multiple daily phlebotomies, red blood cell salvage and antifibrinolytic agents for bleeding patients, consideration of removal of central venous and arterial catheters when no longer required for physiologic monitoring, threshold-based transfusion policy, and healthcare professional education. CONCLUSIONS: There are many strategies of blood conservation for critically ill patients. The effects of these strategies on phlebotomy volumes, hemoglobin and hematocrit levels, transfusion requirements, clinical outcomes, as well as intensive care unit and laboratory resources and costs should be further evaluated.
OBJECTIVE: To describe blood conservation strategies for critically illpatients. DATA SOURCES: By using a predefined strategy, we searched the electronic databases of Medline, EMBASE, CINAHL, the Cochrane database of systematic reviews, Cochrane central register of controlled trials, ACP Journal Club, Database of abstracts of reviews and effects, and HealthSTAR for descriptions and evaluations of strategies of blood conservation among critically illpatients. DATA SUMMARY: A number of blood conservation strategies have been used to prevent or treat anemia among critically illpatients. These include restrictive diagnostic phlebotomy using small-volume or pediatric phlebotomy tubes, point-of-care and inline bedside microanalysis, minimization of diagnostic sample waste, minimization of routine multiple daily phlebotomies, red blood cell salvage and antifibrinolytic agents for bleedingpatients, consideration of removal of central venous and arterial catheters when no longer required for physiologic monitoring, threshold-based transfusion policy, and healthcare professional education. CONCLUSIONS: There are many strategies of blood conservation for critically illpatients. The effects of these strategies on phlebotomy volumes, hemoglobin and hematocrit levels, transfusion requirements, clinical outcomes, as well as intensive care unit and laboratory resources and costs should be further evaluated.
Authors: Katherine Steffen; Allan Doctor; Julie Hoerr; Jeff Gill; Chris Markham; Sarah M Brown; Daniel Cohen; Rose Hansen; Emily Kryzer; Jessica Richards; Sara Small; Stacey Valentine; Jennifer L York; Enola K Proctor; Philip C Spinella Journal: Pediatrics Date: 2017-07-13 Impact factor: 7.124
Authors: Oliver Spelten; Fritz Fiedler; Robert Schier; Wolfgang A Wetsch; Jochen Hinkelbein Journal: J Clin Monit Comput Date: 2015-12-01 Impact factor: 2.502
Authors: Amartya Mukhopadhyay; Hwee S Yip; Dimple Prabhuswamy; Yiong H Chan; Jason Phua; Tow K Lim; Patricia Leong Journal: Crit Care Date: 2010-01-27 Impact factor: 9.097