Impact of minimizing diagnostic blood loss in the critically ill

Dolman, Heather; Evans, Kelly; Zimmerman, Lisa Hall; Lavery, Todd; Baylor, Alfred E.; Wilson, Robert F.; Tyburski, James G.

doi:10.1016/j.surg.2015.05.018

Cited by 42 publications

(33 citation statements)

References 9 publications

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“…Fifty-five percent of all critically ill trauma patients receive an RBC transfusion during their ICU stay; approximately one-half of all transfusions occur five or more days after ICU admission (6). Although some late RBC transfusions are attributable to operative and phlebotomy blood loss (7), a growing body of evidence suggests that trauma patients are also affected by iron dysregulation and suppression of erythropoiesis (8)(9)(10). Iron supplementation and exogenous erythropoietin administration have not reliably increased Hb levels or decreased RBC transfusions (11)(12)(13).…”

mentioning

confidence: 99%

The Postinjury Inflammatory State and the Bone Marrow Response to Anemia

Loftus¹,

Mira²,

Miller³

et al. 2018

Am J Respir Crit Care Med

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mentioning

confidence: 99%

The Postinjury Inflammatory State and the Bone Marrow Response to Anemia

Loftus¹,

Mira²,

Miller³

et al. 2018

Am J Respir Crit Care Med

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“…More recently, Dolman et al . () described a daily blood volume removed of 31·7 ± 15·5 mL. The presence of indwelling arterial catheter increases the number of blood tests conducted by 33% and the amount of blood sampled by 44% (Hayden et al, ).…”

Section: Post‐operative Managementmentioning

confidence: 99%

“…In critically ill patients, Silver et al (1993) reported that over a week, a mean blood volume of 257·4 mL was sent to the laboratory. More recently, Dolman et al (2015) described a daily blood volume removed of 31·7 ± 15·5 mL. The presence of indwelling arterial catheter increases the number of blood tests conducted by 33% and the amount of blood sampled by 44% (Hayden et al, 2012).…”

Section: Avoiding Iatrogenic Blood Lossmentioning

confidence: 99%

Blood conservation in cardiac surgery

Blaudszun

Butchart

Klein

2017

Transfusion Medicine

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This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia. The management of haematological abnormalities, most frequently functional iron deficiency, is a matter for debate. However, iron supplementation therapy is increasingly commonly administered. Intra-operatively, antifibrinolytics should be routinely used, whereas the cardiopulmonary bypass strategy should be adapted to minimise haemodilution secondary to circuit priming. There is less evidence to recommend minimally invasive surgery. Cell salvage and point-of-care tests should also be a part of the routine care. Post-operatively, any unnecessary iatrogenic blood loss should be avoided.

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“…One method, cell recovery, involves salvaging blood lost during patient's surgery and re-infusing it back into the patient, if s/he has a high risk of surgical bleeding (11); these patients have a much greater risk of postoperative anemia (12). Physicians should also be mindful of minimizing diagnostic testing via phlebotomy or using smaller tubes, as diagnostic phlebotomy can contribute to anemia (13).…”

Section: Nüzhet Mert şEntürk Editormentioning

confidence: 99%