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Related Experiment Videos

Invasive line placement in critically ill patients: do hemostatic defects matter?

T G DeLoughery1, J M Liebler, V Simonds

  • 1Department of Pathology, Oregon Health Sciences University, Portland, USA.

Transfusion
|September 1, 1996
PubMed
Summary

Many intensive care patients have hemostatic defects before invasive line placement. Prophylactic blood component use is often unnecessary, as bleeding risk is low and physician experience is key.

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Area of Science:

  • Critical Care Medicine
  • Hematology
  • Medical Device Placement

Background:

  • Prophylactic blood component transfusion is common before invasive line placement in patients with coagulation defects.
  • Epidemiology of hemostatic defects in these patients is poorly understood.

Purpose of the Study:

  • Determine the proportion of ICU patients with hemostatic defects before invasive line placement.
  • Assess physician interventions to correct these defects.
  • Evaluate the incidence of bleeding complications post-procedure.

Main Methods:

  • Retrospective chart review of 490 intensive care unit (ICU) patients.
  • Analysis of 938 arterial, pulmonary artery, and central venous line placements.

Main Results:

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  • 41% of patients had at least one hemostatic defect; 27% had severe abnormalities.
  • 17% lacked preprocedure laboratory evaluation.
  • Physician correction attempts were made in 37% of patients with defects.
  • Low incidence of bleeding complications (16 patients), with only two life-threatening.

Conclusions:

  • Invasive lines are frequently placed in patients with hemostatic defects, often without correction.
  • Hemorrhage rates are low, linked more to physician experience than hemostatic defects.
  • Preprocedure blood component use is generally not indicated, except for severe abnormalities.