Blood conservation in the intensive care unit.
OBJECTIVE
To describe blood conservation strategies for critically ill patients.


METHODS
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.


METHODS
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.
Fowler
Robert A
RA
Department of Medicine and Interdepartmental Division of Critical Care Medicine, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada.
Berenson
Matthew
M
D000740:Anemia / Q000097:blood* / Q000209:etiology / Q000517:prevention & control*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000379:methods; D003422:Critical Care / Q000379:methods*; D017707:Erythrocyte Transfusion / Q000379:methods; D006470:Hemorrhage / Q000209:etiology; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units; D007430:Intraoperative Care / Q000379:methods; D018962:Phlebotomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D012307:Risk Factors
D006490:Hemostatics