Phlebotomy in the intensive care unit: strategies for blood conservation.
The quality and economy of critical care could both be improved if blood losses due to phlebotomy and sampling from indwelling catheters for unnecessary diagnostic testing were curtailed. Practice guidelines can help to break bad diagnostic 'habits', such as fever work-ups that require substantial blood to be drawn yet typically yield little useful information. Invasive hemodynamic monitoring is associated with morbidity due to blood loss as well as infection, and newer noninvasive technologies should be encouraged. Several devices allow blood that would otherwise be wasted during sampling to be returned to the patient aseptically. Point-of-care testing uses microliter quantities of blood, has acceptable precision, and can provide valuable diagnostic information while being minimally invasive.
Barie
Philip S
PS
Department of Surgery, Division of Critical Care and Trauma, Weill Medical College of Cornell University; Anne and Max A Cohen Surgical ICU, New York-Presbyterian Hospital-Weill Cornell Medical Center, New York, New York, USA. pbarie@med.cornell.edu
D001793:Blood Preservation / Q000379:methods*; D003422:Critical Care / Q000379:methods* / Q000592:standards*; D016638:Critical Illness / Q000145:classification* / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D018962:Phlebotomy / Q000379:methods*; D019095:Point-of-Care Systems; D017410:Practice Guidelines as Topic; D013048:Specimen Handling / Q000379:methods / Q000592:standards