title: Approximate iatrogenic blood loss in medical intensive care patients and the causes of anemia.
abstract: BACKGROUND
  Anemia is the most common hematologic problem worldwide especially in developing world. There are many causes of anemia in ICU patient such as gastrointestinal bleeding, anemia of chronic inflammation, trauma or surgery. Patient who were admitted in the ICU need to have a lot of blood tests related to their illness and for further treatment, however that can cause decrease of hematocrit or anemia.
  
  
  OBJECTIVE
  To identify the estimate volume of blood drawn from medical ICU patients and find out whether the volume of blood drawn effects the Hemoglobin/Hematocrit (Hb/Hct) or anemia and to identify the cause of anemia in ICU patient.
  
  
  METHODS
  This is an observation prospective cohort study collecting the volume of blood drawn from patients who were admitted to ICU Thammasat university hospital during 1st October 2007 through 31st March 2008.
  
  
  RESULTS
  This study found the mean volume of blood samples drawn from ICU patients is 77.8 ml. Sixty-eight percents of patients had a decrease Hb/Hct level during admission and around sixteen percent had anemia during admission. There is no statistically significant between the volume of blood drawn and the decrease of Hb/Hct.
  
  
  CONCLUSIONS
  Decrease of Hb/Hct or anemia are common in ICU patient. This study showed that iatrogenic blood loss for laboratory investigation is one of the cause of anemia. We concluded that physician should order phlebotomy for necessary investigation for the most effective of diagnosis and treatment, but the less complication.
authors.affiliation: Department ofMedicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
authors.forename: Pitima
authors.initials: P
authors.lastname: Tosiri
authors.forename: Nonglak
authors.initials: N
authors.lastname: Kanitsap
authors.forename: Apichart
authors.initials: A
authors.lastname: Kanitsap
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology*; D001810:Blood Volume / Q000502:physiology*; D005260:Female; D006400:Hematocrit; D006403:Hematologic Tests; D006454:Hemoglobins / Q000032:analysis; D006785:Hospitals, University; D006801:Humans; D007049:Iatrogenic Disease; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D018962:Phlebotomy / Q000009:adverse effects*; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins