Blood Loss From Diagnostic Laboratory Tests in Critically III Patient and Anemia

Abstract

Objective: Anemia is very common problem in critically ill patients, and it has many deleterious effects of morbidity and mortality, decreased in oxygen carrying capacity. Phlebotomy is an important factor contributing to anemia and the need for transfusion. We aimed to evaluate the volumes of blood drawn for laboratory tests from critically ill patients, and effect on anemia and transfusion practices. Materials and Methods: The study was conducted on 60 critically ill patients. Data were recorded daily including volume of the withdrawn blood, hemoglobin (Hb), indication for transfusion, and number of units transfused. Acute Physiology and Chronic Health Evaluation (APACHE) II ve Sequential Organ Failure Assessment (SOFA) scores, the length of stay (LOS) in the intensive care unit (ICU). Results: Thirty six of the patients (60%) that transfused had significantly higher admitting APACHE II and SOFA scores (p<0.01, p<0.001). The average total volume drawn per patient was 13.05 mL for the 24-hour period except the first day in admission the ICU. The mean volume drawn the first day was detected as 27.90 mL. Total volumes drawn were significantly higher in patients that transfused at the end of second and third week (p<0.001, p<0.001). The mean pretransfusion Hb level was 8.17 g/dL, and 44.5% of all transfusions were performed within the first week. The mean ICU LOS was longer in transfused patients (p<0.001) and mortality in the transfused patients also was significantly higher (p<0.05). Conclusion: Blood drawn and transfusion need increased with prolonged ICU stay. Additionally, patients’ health condition affects the requirement of transfusion. (Journal of the Turkish Society of Intensive Care 2010; 8: 61-5)

Keywords

• Anemia
• phlebotomy
• laboratory testing
• intensive care
• critically ill patient