Volume of blood removed for analytical purposes during hospitalization of low-birthweight infants

Iatrogenic hazards may be induced by blood sampling in very-low-birthweight neonates. We report the number and types of analyses performed on 20 neonates with a birthweight below 1500 g during their first four weeks of hospitalization. Blood was sampled one to 13 times per infant per day on 382 of the 435 total days of hospitalization. The average blood loss was 7 to 51 mL per kilogram of body weight per four weeks--that is, from 5 to 45% of the calculated total blood volume. Of the blood removed, about 25% was in excess of the need for analytical procedures. Of the analyses, 40% were for acid-base, sodium, and potassium analyses--analyses for which transcutaneous methodology has been or is being developed. We conclude that because of the risks for low-birthweight neonates, procedures for blood sampling and analysis should periodically be reviewed, so as to minimize the number of samplings and the amount of blood removed.