Patient Blood Management: Mixing Versus Discard Methods for Central Venous Catheter Blood Specimen Collection

Area of Science:

• Clinical Laboratory Science
• Patient Blood Management
• Medical Device Technology

Background:

• Hospital-acquired anemia is a significant concern, often linked to laboratory blood draw practices.
• Current laboratory specimen techniques may lead to unnecessary blood waste and increased patient risk.
• Patient Blood Management (PBM) programs aim to optimize blood utilization and minimize transfusion needs.

Purpose of the Study:

• To compare the mixing versus discard methods for laboratory specimen collection in an acute care setting.
• To evaluate the impact of these methods on hemoglobin levels and transfusion rates.
• To assess the influence of central venous access device (CVAD) type on hemolysis and erroneous results.

Main Methods:

• A quasi-experimental study over 30 months compared mixing and discard blood draw techniques.
• Primary endpoints included delta hemoglobin (Hgb) and transfusion rates.
• Secondary endpoints monitored redraws due to hemolysis, erroneous results, and CVAD type.

Main Results:

• The mixing method demonstrated non-inferiority to the discard method in terms of Hgb levels and transfusion rates.
• CVAD type did not significantly impact hemolysis rates or the occurrence of erroneous results.
• The mixing method showed potential for cost savings by eliminating the need for external blood management devices.

Conclusions:

• The mixing method effectively reduces blood waste and hospital-acquired anemia within PBM programs.
• Implementation of the mixing method is feasible across various healthcare settings.
• While not definitively superior, the mixing method offers a viable, cost-effective alternative for laboratory specimen collection.