在成年重症监护病房的常规实验室检测中,尽量减少从中央静脉导管中丢弃的血液体积
Ivana Lapić1,2, Josipa Kostelac3, Luka Bielen3,4
1Department of Laboratory Diagnostics, University Hospital Center Zagreb, Zagreb, Croatia.
Diagnosis (Berlin, Germany)
|July 7, 2025
概括
将中央静脉导管 (CVC) 的丢弃血液减少到3毫升,并使用较小的管道进行全血计数 (CBC),可显著减少46%的血液损失. 这种修改后的协议确保了安全的实验室测试,同时最大限度地减少了阳性致血性血液损失.
科学领域:
- 临床病理学 临床病理学
- 医疗器械技术 医疗器械技术
- 患者安全 患者安全
背景情况:
- 创血性失血是重症监护室 (ICU) 中的一个重要问题.
- 中枢静脉导管 (CVC) 经常用于取血样,通常需要丢弃体积.
- 减少废弃物量可以减轻患者的血液损失和相关并发症.
研究的目的:
- 评估从CVCs减少废弃血液体积从10毫升降至3毫升的有效性.
- 评估3毫升全血细胞计 (CBC) 管用2毫升管替换3毫升全血细胞计 (CBC) 管的影响.
- 为了确定这些修改是否保持了实验室测试结果的准确性.
主要方法:
- 对52名成年ICU住院患者进行了比较研究.
- 血液样本采用3毫升的废弃体积从CVC抽取.
- 配对测试样本 (5毫升血清管,2毫升EDTA管) 和常规样本被分析为临床化学和CBC.
主要成果:
- 在大多数参数的测试样本和例行样本之间观察到高相关性 (ρ>0.90).
- 对于血红蛋白和其他分析物来说,发现了轻微的,临床上无意义的偏差.
- 在测试样本和常规样本之间没有发现统计学上显著的差异 (p>0.05).
- 该方案使抽取的血液量减少了46%.
结论:
- 来自CVC的3毫升丢弃体积对于常规血液学和临床化学测试是安全的.
- 这种双重方法有效地减少了ICU患者的阳性血流.
- 修改后的协议提供了一个切实可行的解决方案,以尽量减少在实验室采样期间的血液损失.
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