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Related Experiment Videos

Blood loss from laboratory tests.

Dirk Wisser1, Klaus van Ackern, Ernst Knoll

  • 1Department of Clinical Chemistry and Laboratory Medicine, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.

Clinical Chemistry
|September 23, 2003
PubMed
Summary

Laboratory blood loss is minimal for most patients, but higher in intensive care units and after cardiovascular surgery. Reporting cumulative blood loss did not reduce testing-related blood loss.

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Area of Science:

  • Clinical Pathology
  • Laboratory Medicine
  • Patient Safety

Background:

  • Laboratory testing is a significant source of iatrogenic blood loss in hospitals.
  • Newborns and intensive care unit (ICU) patients are particularly vulnerable to blood loss from frequent sampling.

Purpose of the Study:

  • To quantify blood loss attributable to laboratory diagnostic tests in a large cohort of hospitalized patients.
  • To assess the impact of reporting cumulative blood loss on reducing sample volumes.

Main Methods:

  • Blood loss was estimated by multiplying the number and volume of sampling tubes collected from 2654 adult inpatients.
  • A comparison was made before and after implementing a system for reporting cumulative blood loss to physicians, alongside educational initiatives.

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Main Results:

  • Ninety-five percent of patients experienced <196 mL blood loss; 5% had >200 mL, primarily ICU patients.
  • Blood gas analyses constituted a significant portion of blood loss (19-34%) in surgical ICUs.
  • Cumulative blood loss reporting did not alter the mean number of tests per patient (44 vs. 46).

Conclusions:

  • Blood loss from laboratory testing is generally not a clinical concern for most inpatients.
  • ICU patients and those undergoing cardiovascular surgery experience greater blood loss from diagnostic testing.
  • Interventions to report cumulative blood loss did not effectively reduce blood loss from laboratory tests.