Reducing Blood Loss by Changing to Small Volume Tubes for Laboratory Testing.
Reducing Blood Loss by Changing to Small Volume Tubes for Laboratory Testing.
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DOI：
10.1016/j.mayocpiqo.2020.08.007
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Franco PM
中科院分区：
文献类型：
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作者：
Wu Y;Spaulding AC;Borkar S;Shoaei MM;Mendoza M;Grant RL;Barber BW;Johns GS;Franco PM
通过在整个医院使用小容量试管进行常规实验室检测来减少诊断性失血量，因为实验室检测的失血量对患者来说可能很大，并可能导致医院获得性贫血。评估2017年4月1日至2018年6月1日住院患者的诊断性失血量。比较不同楼层和不同类型的血液学、基本代谢组和凝血试验的每名住院患者的干预前、干预期间和干预后的平均诊断失血量。平均血红蛋白水平、每位住院患者的输血量和重划百分比也进行了比较。所有3种检测的采血总量在每个实施阶段都有所减少；然而，只有住进移植和重症监护病房（T/CC）的患者血红蛋白水平升高。此外，整个实施阶段的输血量也显著减少。在T/CC病房住院的患者中，输血的发生率风险比降低得更多。最后，在所有单位的总体重绘百分比没有显著差异。在所有单位中，使用小容量管代替标准尺寸管显着减少诊断失血量25.7%，在T/CC单位中显着减少22.9%。此外，各单位的输血次数均有所减少，其中T/CC单位下降幅度最大。在T/CC病房的患者中观察到平均血红蛋白水平升高，而在所有病房中没有相应的百分比变化。
To reduce diagnostic blood loss by using small volume tubes for routine laboratory testing throughout the hospital, as blood loss from laboratory testing can be substantial for patients and may lead to hospital-acquired anemia. Diagnostic blood loss was evaluated in hospitalized patients between April 1, 2017, and June 1, 2018. The preintervention, during intervention, and postintervention mean diagnostic blood loss per hospitalized patient was compared across the floors and for each type of tube for hematology, basic metabolic panel, and coagulation tests. Mean hemoglobin levels, blood transfusions per hospitalized patient, and percent redraws were also compared. The total volume of blood drawn for all the 3 tests decreased across each implementation phase; however, only patients admitted to the transplant and critical care (T/CC) units had increased hemoglobin levels. In addition, there was a significant reduction in transfusions across implementation phases. The incidence risk ratio for transfusion reduced even more in patients admitted to the T/CC units. Finally, there was no significant difference in the overall percent redraws across all the units. The use of small volume tubes in exchange for standard sized tubes markedly decreased diagnostic blood loss by 25.7% in all the units and 22.9% in the T/CC units. Also, the number of transfusions decreased across units, with the greatest decrease in the T/CC units. An increase in mean hemoglobin levels was observed specifically in patients admitted to the T/CC units, with no corresponding change in percent redraws across all the units.