Utilização de sistema fechado para coleta de sangue e necessidade de transfusão em pacientes graves

Rezende, Ederlon; Ferez, Marcus Antônio; Silva, João Manoel da; Oliveira, Amanda Maria Ribas Rosa de; Viana, Renata Andréa Pietro Pereira; Mendes, Ciro Leite; Toledo, Diogo de Oliveira; Neto, Miguel Costa Ribeiro; Setoyama, Tatiane Akemi

doi:10.1590/s0103-507x2010000100003

Cited by 9 publications

(5 citation statements)

References 46 publications

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“…We identified eight RCTs which evaluated blood conservation devices, six with arterial lines [119][120][121][122][123][124][125], and one with PICC lines [126]…”

Section: Evidence Summarymentioning

confidence: 99%

Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

et al. 2020

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Objective: To develop evidence-based clinical practice recommendations regarding transfusion practices in nonbleeding, critically ill adults. Design: A task force involving 13 international experts and three methodologists used the GRADE approach for guideline development. Methods: The task force identified four main topics: red blood cell transfusion thresholds, red blood cell transfusion avoidance strategies, platelet transfusion, and plasma transfusion. The panel developed structured guideline questions using population, intervention, comparison, and outcomes (PICO) format. Results: The task force generated 16 clinical practice recommendations (3 strong recommendations, 13 conditional recommendations), and identified five PICOs with insufficient evidence to make any recommendation. Conclusions: This clinical practice guideline provides evidence-based recommendations and identifies areas where further research is needed regarding transfusion practices and transfusion avoidance in non-bleeding, critically ill adults.

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“…We identified eight RCTs which evaluated blood conservation devices, six with arterial lines [119][120][121][122][123][124][125], and one with PICC lines [126]…”

Section: Evidence Summarymentioning

confidence: 99%

Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

et al. 2020

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“…Although three studies did not observe a statistically significant decrease in hemoglobin concentration (33–35), one study reported a statistically significant hemoglobin decline in their control patients compared with those with the VAMP device (∆hemoglobin = –21.3 ± 23.2 g/L vs –14.4 ± 20.8 respectively, p = 0.02) (30). Another study similarly observed a significant difference in final hemoglobin between both groups (VAMP hemoglobin 104 ± 23.7 to 97 ± 13 g/L vs controls hemoglobin 105 ± 22.4 to 91 ± 18.0g/L; p = 0.006) (21). Only two studies observed a significant decrease in transfusion number in the intervention group (30, 33).…”

Section: Resultsmentioning

confidence: 84%

“…Seven research groups evaluated the use of an arterial closed blood sampling device in adult patients: one was a pre-post trial with a subgroup analysis published subsequently (29,30), one was a prospective crossover study (31), and five were RCTs (21,(32)(33)(34)(35). Four studies compared diagnostic blood loss with the venous-arterial blood management protection (VAMP) device versus standard blood sampling (31)(32)(33)(34).…”

Section: Resultsmentioning

confidence: 99%

“…Overall ROB was high in almost all included RCTs ( n = 11; 92%) ( Supplemental Digital Content 4 , http://links.lww.com/PCC/C216), only the article by Rezende et al (21) was considered containing an unclear ROB. The most frequent reasons for high ROB were lack of randomization with allocation concealment and lack of blinding for the intervention and/or the outcome measure of interest.…”

Section: Resultsmentioning

confidence: 99%

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Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

François

Charlier

Balandier

et al. 2022

Pediatric Critical Care Medicine

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Blood sampling is a recognized contributor to hospital-acquired anemia. We aimed to bundle all published neonatal, pediatric, and adult data regarding clinical interventions to reduce diagnostic blood loss.DATA SOURCES: Four electronic databases were searched for eligible studies from inception until May 2021.STUDY SELECTION: Two reviewers independently selected studies, using predefined criteria. DATA EXTRACTION:One author extracted data, including study design, population, period, intervention type and comparator, and outcome variables (diagnostic blood volume and frequency, anemia, and transfusion).DATA SYNTHESIS: Of 16,132 articles identified, we included 39 trials; 12 (31%) were randomized controlled trials. Among six types of interventions, 27 (69%) studies were conducted in adult patients, six (15%) in children, and six (15%) in neonates. Overall results were heterogeneous. Most studies targeted a transfusion reduction (n = 28; 72%), followed by reduced blood loss (n = 24; 62%) and test frequency (n = 15; 38%). Small volume blood tubes (n = 7) and blood conservation devices (n = 9) lead to a significant reduction of blood loss in adults (8/9) and less transfusion of adults (5/8) and neonates (1/1). Point-of-care testing (n = 6) effectively reduced blood loss (4/4) and transfusion (4/6) in neonates and adults. Bundles including staff education and protocols reduced blood test frequency and volume in adults (7/7) and children (5/5). CONCLUSIONS:Evidence on interventions to reduce diagnostic blood loss and associated complications is highly heterogeneous. Blood conservation devices and smaller tubes appear effective in adults, whereas point-of-care testing and bundled interventions including protocols and teaching seem promising in adults and children.

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“…This suggests that minimizing blood wasting should be an important intervention to introduce into clinical practice. Blood conservation devices can help to reduce the amount of blood wasted for line rinsing (21,(28)(29)(30)(31)(32)(33). Arterial closed blood sampling devices such as the Venous-Arterial blood Management Protection device can significantly lower the amount of blood volume discarded (28)(29)(30)34).…”

Section: Discussionmentioning

confidence: 99%

Impact of Blood Sampling on Anemia in the PICU: A Prospective Cohort Study

François

Sauthier

Charlier

et al. 2022

Pediatric Critical Care Medicine

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Fifty percent of children are anemic after a critical illness. Iatrogenic blood testing may be a contributor to this problem. The objectives of this study were to describe blood sampling practice in a PICU, determine patient factors associated with increased sampling, and examine the association among blood sampling volume, anemia at PICU discharge, and change in hemoglobin from PICU entry to PICU discharge.

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Utilização de sistema fechado para coleta de sangue e necessidade de transfusão em pacientes graves

Cited by 9 publications

References 46 publications

Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine

Strategies to Reduce Diagnostic Blood Loss and Anemia in Hospitalized Patients: A Scoping Review

Impact of Blood Sampling on Anemia in the PICU: A Prospective Cohort Study

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