title: Implementation of a multi-parameter Point-of-Care-blood test analyzer reduces central laboratory testing and need for blood transfusions in very low birth weight infants.
abstract: Blood sampling for laboratory testing is a major cause of iatrogenic blood loss and anemia in neonatal intensive care unit [NICU] patients. The objective of the study was to assess whether the implementation of a multi-parameter Point of Care Test [POCT] (Roche, Cobas b221) analyzer affected blood loss for central laboratory testing and need for red blood cell transfusion in our NICU. This was a retrospective observational cohort study in a NICU with comparison of two serial cohorts of 2 years each. Implementation of a multi-parameter POCT decreased central laboratory performed testing for bilirubin (-32% per patient) and electrolytes (-36% per patient). On average, the net blood volume taken per admitted patient for electrolyte testing decreased with 23.7% and 22.2% for bilirubin testing in the second cohort. After implementation of POCT, fewer very low birth weight infants [VLBWI] required blood transfusion (38.9% vs. 50%, p<.05) as the number of transfusion/infants decreased by 48% (1.57 vs. 2.53, p<0.01). The implementation of POCT was cost-efficient for the Belgian national health insurance, cost reduction -8.3% per neonate. We conclude that implementation of a bedside multi-parameter POCT analyzer decreases transfusions among VLBWI by reducing iatrogenic blood loss for central laboratory testing.
authors: Division of Neonatology, Department of Pediatrics, Antwerp University Hospital, Antwerp University, Edegem, Belgium. Ludo.Mahieu@uza.be
authors: Ludo
authors: L
authors: Mahieu
authors: Annick
authors: A
authors: Marien
authors: Jozef
authors: J
authors: De Dooy
authors: Margo
authors: M
authors: Mahieu
authors: Hanne
authors: H
authors: Mahieu
authors: Viviane
authors: V
authors: Van Hoof
mesh_terms: D001530:Belgium; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007753:Laboratories; D019095:Point-of-Care Systems; D012189:Retrospective Studies