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

95PC

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.

Safe Set 240mL

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.

References

  1. 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 
  2. 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
  3. 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 
  4. Goodnough LT, Brecher ME, Kanter MH, et al: Transfusion medicine: Blood transfusion. N Engl J Med 1999; 340:438 - 447
  5. Goodnough LT, Brecher ME, Kanter MH, et al: Transfusion medicine: Blood conservation. N Engl J Med 1999; 340:525-533
  6. Marik PE, Sibbald WJ: Effect of stored-blood transfusion on oxygen delivery in patients with sepsis. JAMA 1993; 269:3024 -3029
  7. Vincent JL, Baron J-F, Reinhart K, et al:Anemia and blood transfusion in critically ill patients. JAMA 2002; 288:1499-1507
  8. 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
  9. 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
  10. Nguyen BV, Bota DP, Melot C, et al: Time course of hemoglobin (See reference #8)
  11. Gleason E, Grossman S, Campbell C: Minimizing diagnostic blood loss in critically ill patients. Am J Crit Care 1992; 1:85-90
  12. 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
  13. Dale JC, Ruby SG: Specimen collection volumes for laboratory tests. Arch Pathol Lab Med 2003; 127:162-168
  14. 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