Blood conservation in the critically ill

The insertion of arterial lines has become a routine procedure for the critically ill. Valuable patient data can be obtained from the arterial line, nursing and laboratory personnel time can be saved, and patient discomfort can be minimized. However, increased blood loss is incurred and may result in nosocomial anemia. This blood loss can be sharply reduced by heightened staff awareness, use of tubing that eliminates the need for discard, and drawing only the volume necessary for laboratory testing. Bedside microchemistry and protocols for obtaining a laboratory test may further decrease blood loss and eliminate the need for blood transfusions to replace iatrogenic blood loss.