title: Safe Reduction of Blood Volume in the Blood Gas Laboratory.
abstract: BACKGROUND
  Phlebotomy is a significant cause of iatrogenic anemia in the critical care environment. It is estimated that one-third of all transfusions of packed red blood cells in intensive care units (ICU) result from phlebotomy. The aims of this study were to determine if utilizing the 1mL blood gas syringe for an adult population would impact the rate at which specimens were acceptable for testing and result reporting based on lab specimen rejection criteria; and to compare blood utilization between the 2 different syringes.
  
  
  METHODS
  This study was conducted in 1 of the adult ICUs at the University of Utah Hospital. Over a baseline period a standard adult 3 mL blood gas syringe was utilized. Subsequently the standard adult syringe was replaced by a 1 mL syringe produced by the same manufacturer with the same heparin concentration.
  
  
  RESULTS
  The change to the 1 mL syringe had no effect on specimen integrity in regards to laboratory's ability to process the specimen. With use of the 1 mL syringe there was a 60% reduction in the volume of blood drawn compared with the baseline period.
  
  
  CONCLUSIONS
  Standardizing the 1 mL syringe for Blood Gas Laboratory tests will reduce patient blood loss without appreciably affecting specimen rejection relative to current rates.
authors.affiliation: Pulmonary Laboratory phillip.jensen@hsc.utah.edu.
authors.forename: Phillip R
authors.initials: PR
authors.lastname: Jensen
authors.affiliation: Department of Internal Medicine, Section of Respiratory, Critical Care, Occupation (Pulmonary) Medicine, University of Utah Health Sciences, Salt Lake City, UT.
authors.forename: Boaz A
authors.initials: BA
authors.lastname: Markewitz
mesh_terms: D000740:Anemia / Q000517:prevention & control*; D001784:Blood Gas Analysis / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D018962:Phlebotomy / Q000009:adverse effects* / Q000379:methods*; D014589:Utah
keywords: blood gas analysis; blood utilization; clinical chemistry; iatrogenic anemia; management/administration; phlebotomy