Evaluation of a new blood-conserving arterial line system for patients in intensive care units

Silver, Mitchell; Jubran, Hala; Stein, Susan; McSweeney, Thomas D.; Jubran, Fuad

doi:10.1097/00003246-199304000-00008

Cited by 39 publications

(14 citation statements)

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“…This device has been described previously [16]. Briefly, it is attached to the existing arterial catheter.…”

Section: Methodsmentioning

confidence: 99%

“…Reduction of the discarded blood volume is possible using a three-way connection [15] or a dedicated blood conservation system [16]. While data exist to show that such devices may reduce the degree of blood loss [17,18] resulting in higher Hb levels [19], no previous study has demonstrated any significant effect of these devices on the amount of blood transfusion.…”

Section: Introductionmentioning

confidence: 99%

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The use of a blood conservation device to reduce red blood cell transfusion requirements: a before and after study

et al. 2010

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IntroductionAnaemia and the associated need for packed red blood cell (PRBC) transfusions are common in patients admitted to the intensive care unit (ICU). Among many causes, blood losses from repeated diagnostic tests are contributory.MethodsThis is a before and after study in a medical ICU of a university hospital. We used a closed blood conservation device (Venous Arterial blood Management Protection, VAMP, Edwards Lifesciences, Irvine, CA, USA) to decrease PRBC transfusion requirements. We included all adult (≥18 years) patients admitted to the ICU with indwelling arterial catheters, who were expected to stay more than 24 hours and were not admitted for active gastrointestinal or any other bleeding. We collected data for six months without VAMP (control group) immediately followed by nine months (active group) with VAMP. A restrictive transfusion strategy in which clinicians were strongly discouraged from any routine transfusions when haemoglobin (Hb) levels were above 7.5 g/dL was adopted during both periods.ResultsEighty (mean age 61.6 years, 49 male) and 170 patients (mean age 60.5 years, 101 male) were included in the control and active groups respectively. The groups were comparable for age, gender, Acute Physiology and Chronic Health Evaluation (APACHE) II score, need for renal replacement therapy, length of stay, and Hb levels on discharge and at transfusion. The control group had higher Hb levels on admission (12.4 ± 2.5 vs. 11.58 ± 2.8 gm/dL, P = 0.02). Use of a blood conservation device was significantly associated with decreased requirements for PRBC transfusion (control group 0.131 unit vs. active group 0.068 unit PRBC/patient/day, P = 0.02) on multiple linear regression analysis. The control group also had a greater decline in Hb levels (2.13 ± 2.32 vs. 1.44 ± 2.08 gm/dL, P = 0.02) at discharge.ConclusionsThe use of a blood conservation device is associated with 1) reduced PRBC transfusion requirements and 2) a smaller decrease in Hb levels in the ICU.

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“…This device has been described previously [16]. Briefly, it is attached to the existing arterial catheter.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The use of a blood conservation device to reduce red blood cell transfusion requirements: a before and after study

et al. 2010

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“…Indwelling arterial catheters are commonly used to monitor blood pressure continuously and to provide a means to frequently sample arterial blood ( Silver et al . 1993 ).…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

Blood gas analysis: a study of blood loss in intensive care

Andrews

Waterman

Hillier

1999

Journal of Advanced Nursing

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This paper describes a quantitative study conducted on an intensive care unit in the north of England. It involved the collection of data from the existing records of 65 patients consecutively sampled from a predetermined date provided that they stayed more than 24 hours and had an arterial line in situ. As patient records were used, ethical approval was not necessary. The objectives of the study were to quantify the mean number of blood gas samples taken per patient and estimate the mean blood loss resulting from this, including discard volume. Limitations include reliance on records and lack of an economic evaluation. The results show that blood loss in this study was greater than that reported elsewhere. Patients who were ventilated for 24 hours or more had a statistically significant greater blood loss when compared to those who were not (P < 0.001). A subgroup of patients undergoing renal replacement therapy had the greatest blood loss (mean 55.18 ml per day). This loss was statistically significant when compared to patients not in acute renal failure (P=0.007). When patients undergoing multiple therapies normally associated with increased sampling were compared to patients not receiving such therapies, there was no statistically significant difference in blood loss. The need to change current nursing practice to reduce iatrogenic anaemia is emphasized.

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“…Blood conservation systems have also been designed to eliminate blood discards. 30,31 Such systems in combination with advances in in-line monitoring of laboratory parameters, 32,33 i.e. arterial blood gases, could greatly reduce phlebotomy blood loss.…”

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confidence: 99%