Authors :
Dr. Yuvaraj Arumugam; Dr. P. Vivekananthan; Dr. Sivakumar M Nandakumar
Volume/Issue :
Volume 11 - 2026, Issue 4 - April
Google Scholar :
https://tinyurl.com/3kedacye
Scribd :
https://tinyurl.com/5xt9ammj
DOI :
https://doi.org/10.38124/ijisrt/26apr2048
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Background: Frequent and unnecessary sampling could lead to blood loss, which is a major factor causing
iatrogenic anaemia. Optimising blood sampling practices could help prevent the need for blood transfusions. Our study aims
to assess the blood loss, haemoglobin drop, and blood transfusion requirement due to blood sampling in critical care units.
Methods: A prospective observational study was carried out in the adult critical care units of a tertiary care hospital over
three months in Coimbatore, South India. A total of 193 consecutive patients were included by convenience sampling. Blood
loss incurred other than blood sampling was observed to negate the bias. Results: Thirty-one (15.8%) patients experienced
a significant drop in haemoglobin, and the average blood volume drawn was 87 ml per patient during ICU admission.
Patients with invasive catheters incurred higher blood loss and received more blood transfusions (63 units) compared to
those with non-invasive catheters (4 units). Unplanned blood samples (stat) were 1186 (9.96 per patient) with invasive
catheters. The calculated p-value for blood wastage and transfusion is highly significant (p=0.013). The highly substantial
p-values were seen for blood withdrawn between invasive sampling and peripheral sampling per patient and per day
(p=0.000 & p=0.00). Conclusion: Our study suggests that reducing the incidence of iatrogenic anaemia and blood transfusion
requirements is possible using a closed blood sampling system, especially for sicker patients and those expected to stay for
more than 5 days, avoiding unplanned and frequent investigations, using small-volume blood collection tubes, and planned
blood sampling timings 12 hours apart as an ICU protocol.
Keywords :
Anaemia; Blood Sampling; Blood Transfusion; Hospital-Acquired Anaemia; Intensive Care Unit; Packed Red Blood Cells; Small Volume Tubes.
References :
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- Tyler Edward James, Rebecca Barty, Yang Liu, Bram Rochwerg, Nancy Heddle, Deborah M Siegal; Blood Loss Due to Laboratory Testing in Critical Care Patients: A Retrospective Cohort Study. Blood 2018; 132 (Supplement 1): 4885. doi: https://doi.org/10.1182/blood-2018-99-114289
- Adams JC, Barrett C, Spruyt M. Iatrogenic blood loss in critical care: A prospective observational study conducted at Universitas Academic Hospital in the Free State Province, South Africa. South Afr J Crit Care. 2022 Aug 5;38(2) doi: 10.7196/SAJCC. 2022.v38i2.539.
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- Cioc A, Fodor R, Benedek O, Moldovan A, Copotoiu SM. Blood sampling as a cause of anemia in a general ICU - a pilot study. Rom J Anaesth Intensive Care. 2015 Apr;22(1):13-16. PMID: 28913450; PMCID: PMC5505326.
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- Keogh S, Mathew S, Ullman AJ, Rickard CM, Coyer F. What blood conservation practices are effective at reducing blood sampling volumes and other clinical sequelae in intensive care? A systematic review. Aust Crit Care. 2023 Nov;36(6):1129-1137. doi: 10.1016/j.aucc.2022.12.002. Epub 2023 Jan 10. PMID: 36635184.
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- Dolman, H.S.; Evans, K.; Zimmerman, L.H.; Lavery, T.; Baylor, A.E.; Wilson, R.F.; Tyburski, J.G. Impact of minimizing diagnostic blood loss in the critically ill. Surgery 2015, 158, 1083–1087.
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Background: Frequent and unnecessary sampling could lead to blood loss, which is a major factor causing
iatrogenic anaemia. Optimising blood sampling practices could help prevent the need for blood transfusions. Our study aims
to assess the blood loss, haemoglobin drop, and blood transfusion requirement due to blood sampling in critical care units.
Methods: A prospective observational study was carried out in the adult critical care units of a tertiary care hospital over
three months in Coimbatore, South India. A total of 193 consecutive patients were included by convenience sampling. Blood
loss incurred other than blood sampling was observed to negate the bias. Results: Thirty-one (15.8%) patients experienced
a significant drop in haemoglobin, and the average blood volume drawn was 87 ml per patient during ICU admission.
Patients with invasive catheters incurred higher blood loss and received more blood transfusions (63 units) compared to
those with non-invasive catheters (4 units). Unplanned blood samples (stat) were 1186 (9.96 per patient) with invasive
catheters. The calculated p-value for blood wastage and transfusion is highly significant (p=0.013). The highly substantial
p-values were seen for blood withdrawn between invasive sampling and peripheral sampling per patient and per day
(p=0.000 & p=0.00). Conclusion: Our study suggests that reducing the incidence of iatrogenic anaemia and blood transfusion
requirements is possible using a closed blood sampling system, especially for sicker patients and those expected to stay for
more than 5 days, avoiding unplanned and frequent investigations, using small-volume blood collection tubes, and planned
blood sampling timings 12 hours apart as an ICU protocol.
Keywords :
Anaemia; Blood Sampling; Blood Transfusion; Hospital-Acquired Anaemia; Intensive Care Unit; Packed Red Blood Cells; Small Volume Tubes.