title: Closed system for blood sampling and transfusion in critically ill patients.
abstract: OBJECTIVE
  Anemia is common in severely ill patients, and blood sampling plays a relevant causative role. Consequently, blood transfusions are frequent an related to several complications. Trying to reduce the transfusion-related risk, minimizing blood loss is mandatory. Thus, this work aimed to evaluate a closed blood sampling system as a strategy to spare unnecessary blood losses and transfusions.
  
  
  METHODS
  This was a prospective, randomized, controlled, multicenter, 6 months, clinical trial. The patients were assigned to either VAMP (Venous Arterial Blood Management Protection) group, using a closed blood sampling system, or control group. The groups' transfusion rate, as well as hemoglobin (Hb) and Hematocrit (Ht) changes were compared for 14 days.
  
  
  RESULTS
  Were included 127 patients, 65 assigned to the control group, and 62 to VAMP. During the intensive care unit stay, both groups experienced both hemoglobin and hematocrit drops. However, when the final Ht and Hb were compared between the groups, a difference was identified with higher values in the VAMP group (p=0.03; p=0.006, respectively). No statistical difference was found for both groups transfusion rates, although the VAMP group had an absolute 12% blood transfusion reduction.
  
  
  CONCLUSIONS
  The use of a closed blood sampling system was able to minimize blood count values changes, however failed to reduce transfusions rate.
authors.affiliation: Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, SP, Brasil.
authors.forename: Ederlon
authors.initials: E
authors.lastname: Rezende
authors.affiliation: Hospital São Francisco, Ribeirão Preto, SP, Brasil.
authors.forename: Marcus Antonio
authors.initials: MA
authors.lastname: Ferez
authors.affiliation: Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, SP, Brasil.
authors.forename: João Manoel da
authors.initials: JM
authors.lastname: Silva Junior
authors.affiliation: Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, SP, Brasil.
authors.forename: Amanda Maria Ribas Rosa de
authors.initials: AM
authors.lastname: Oliveira
authors.affiliation: Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, SP, Brasil.
authors.forename: Renata Andréa Pietro Pereira
authors.initials: RA
authors.lastname: Viana
authors.affiliation: Hospital de Emergência e Trauma Senador Humberto Lucena, João Pessoa, PB, Brasil.
authors.forename: Ciro Leite
authors.initials: CL
authors.lastname: Mendes
authors.affiliation: Hospital de Emergência e Trauma Senador Humberto Lucena, São Paulo, SP, Brasil.
authors.forename: Diogo de Oliveira
authors.initials: Dde O
authors.lastname: Toledo
authors.affiliation: Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, SP, Brasil.
authors.forename: Miguel Costa
authors.initials: MC
authors.lastname: Ribeiro Neto
authors.affiliation: Hospital do Servidor Público Estadual Francisco Morato de Oliveira, São Paulo, SP, Brasil.
authors.forename: Tatiane Akemi
authors.initials: TA
authors.lastname: Setoyama