The Challenge
The majority of patients in the Intensive Care Unit
(ICU) are anemic upon admission, and 30-37% of ICU patients receive
blood transfusions during their stay.1,2
Unfortunately, these allogeneic blood transfusions present the
risk of infection, as well as the potential for circulatory
overload, acute and delayed transfusion reactions, myocardial
dysfunction, and immune modulation.3,4,5,6 While there are many
acknowledged causes of anemia, one contributing factor is venous
and arterial blood sampling (phlebotomy). Critically ill patients
in acute settings within the hospital are exposed to between five
and nearly two dozen blood draws per day. 7,8,9
Our Solution
One method for reducing blood transfusions is to reduce
blood waste or 'discard volume' during diagnostic
phlebotomy.
SafeSet
™ provides a closed, needlefree in-line blood
sampling and conservation system that allows blood discard, which
can vary from 2 to 10 mL per blood draw,10,11-13 to be reinfused,
while protecting both patient and clinician from exposure to
bloodborne pathogens. Using the reported frequency of blood
draws (5-24/day) and the blood waste per draw (2-10 mL), using
SafeSet could save between 20 and 240 mL of blood per patient per
day. Accordingly, the ability to reinfuse blood discard with
SafeSet may help reduce cases of anemia in the ICU, and
subsequently reduce unnecessary transfusions. Not only
does SafeSet™ increase efficiency of the blood
sampling process, but it also increases patient and clinician
safety by maintaining a closed system.
- Hebert PC, Schweitzer I, Calder L, et al: Review of the
clinical practice literature on allogeneic red blood cell
transfusion. Can Med Assoc J 156(11S):S9 -S26,
1997
- Hebert PC, Wells G, Tweeddale M, et al: Does transfusion
practice affect mortality in critically ill patients? Am J Respir
Crit Care Med 1997; 155:1618 -1623
- Hebert PC, Wells G, Blajchman M, et al: A multicenter,
randomized, controlled clinical trial of transfusion requirements
in critical care. N Engl J Med 1999; 340:409 - 417
- Goodnough LT, Brecher ME, Kanter MH, et al: Transfusion
medicine: Blood transfusion. N Engl J Med 1999; 340:438 -
447
- Goodnough LT, Brecher ME, Kanter MH, et al: Transfusion
medicine: Blood conservation. N Engl J Med 1999; 340:525-533
- Marik PE, Sibbald WJ: Effect of stored-blood transfusion on
oxygen delivery in patients with sepsis. JAMA 1993; 269:3024
-3029
- Vincent JL, Baron J-F, Reinhart K, et al:Anemia and blood
transfusion in critically ill patients. JAMA 2002;
288:1499-1507
- Nguyen BV, Bota DP, Melot C, et al: Time course of
hemoglobin concentration in nonbleeding intensive care unit
patients. Crit Care Med 2003; 31:406-410
- Zimmerman JE, Seneff MG, Sun X, et al: Evaluating
laboratory usage in the intensive care unit: Patient and
institutional characteristics that influence frequency of
blood sampling. Crit Care Med 1997; 25:737-748
- Nguyen BV, Bota DP, Melot C, et al: Time course of
hemoglobin (See reference #8)
- Gleason E, Grossman S, Campbell C: Minimizing diagnostic
blood loss in critically ill patients. Am J Crit Care 1992;
1:85-90
- Clapham M, Willis N, Mapleson W: Minimum value of discard
for valid blood sampling from indwelling arterial cannulae. Br
J Anesth 1987; 59:232-235
- Dale JC, Ruby SG: Specimen collection volumes for
laboratory tests. Arch Pathol Lab Med 2003; 127:162-168
- Corwin HL, Gettinger A, Pearl, RG, et al: The CRIT Study:
Anemia and blood transfusion in the critically ill-Current
clinical practice in the United States. Crit Care
Med 2004; 32:1:39-52
