Trends in United States blood collection and transfusion: results from the 2013 AABB Blood Collection, Utilization, and Patient Blood Management Survey

Background: Anemia remains one of the most common comorbidities in intensive care patients worldwide. The cause of anemia is often multifactorial and triggered by underlying disease, comorbidities, and iatrogenic factors, such as diagnostic phlebotomies. As anemia is associated with a worse outcome, especially in intensive care patients, unnecessary iatrogenic blood loss must be avoided. Therefore, this scoping review addresses the amount of blood loss during routine phlebotomies in adult (>17 years) intensive care patients and whether there are factors that need to be improved in terms of patient blood management (PBM). Methods: A systematic search of the Medline Database via PubMed was conducted according to PRISMA guidelines. The reported daily blood volume for diagnostics and other relevant information from eligible studies were charted. Results: A total of 2167 studies were identified in our search, of which 38 studies met the inclusion criteria (9 interventional studies and 29 observational studies). The majority of the studies were conducted in the US (37%) and Canada (13%). An increasing interest to reduce iatrogenic blood loss has been observed since 2015. Phlebotomized blood volume per patient per day was up to 377 mL. All interventional trials showed that the use of pediatric-sized blood collection tubes can significantly reduce the daily amount of blood drawn. Conclusion: Iatrogenic blood loss for diagnostic purposes contributes significantly to the development and exacerbation of hospital-acquired anemia. Therefore, a comprehensive PBM in intensive care is urgently needed to reduce avoidable blood loss, including blood-sparing techniques, regular advanced training, and small-volume blood collection tubes.

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Evaluating the Importance of Patient Blood Management During COVID-19 Pandemic

Anesthesiology and Pain Medicine ◽

10.5812/aapm.112910 ◽

2022 ◽

Vol 11 (6) ◽

Author(s):

Azita Chegini

Keyword(s):

Blood Transfusion ◽

Blood Collection ◽

Patient Blood Management ◽

Blood Products ◽

Blood Management ◽

Platelet Dysfunction ◽

Timely Manner ◽

Public Places ◽

Emergency Procedures ◽

Number Of Patients

: Due to the COVID-19 pandemic, the demand for blood products may decrease as the health care system shifts toward treating the increased number of patients afflicted with COVID-19 and delaying selective surgeries and emergency procedures. One of the most important problems for blood transfusion services during COVID-19 pandemic is the reduction in the number of donors and a decrease in blood stocks. This happens due to the limitations of attendance of donors in blood centers, lack of awareness, misinformation, fear of being infected while donating blood, and restricting the freedom of blood collection teams to attend public places. Blood transfusion services should be prepared and well-responded in a timely manner. In this regard, appropriate use of blood, diminishing unnecessary transfusions, and implementation of patient blood management (PBM) principles are considered as significant measurements. PBM can help maintain blood supply throughout the crisis and reduce the pressure on blood demand. As a result, blood products can be saved for patients who need it urgently. PBM focuses on the patient, as well as the conditions that make patients transfuse blood, such as blood loss, coagulopathy, platelet dysfunction, and anemia. Thus, the majority of health systems in different countries have made recommendations to the PBM in hospitals.

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Implementation of a Comprehensive Patient Blood Management Program for Hospitalized Patients at a Large United States Medical Center

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2021.07.017 ◽

2021 ◽

Author(s):

Matthew A. Warner ◽

Phillip J. Schulte ◽

Andrew C. Hanson ◽

Nageswar R. Madde ◽

Jennifer M. Burt ◽

...

Keyword(s):

United States ◽

Medical Center ◽

Management Program ◽

Hospitalized Patients ◽

Patient Blood Management ◽

Blood Management

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Laboratory medicine contributions to patient blood management concepts

LaboratoriumsMedizin ◽

10.1515/labmed-2017-0148 ◽

2018 ◽

Vol 42 (3) ◽

pp. 81-87

Author(s):

Janine Spethmann ◽

Kathrin Schlüter ◽

Kathrin Schlatterer

Keyword(s):

Turnaround Time ◽

Blood Collection ◽

Laboratory Diagnostics ◽

Patient Blood Management ◽

Blood Management ◽

Management Concepts ◽

Collection Tube ◽

Improvement Measures ◽

Management Project ◽

Potential Improvement

Abstract Background: A review of the literature shows that the role of laboratory diagnostics in the multidisciplinary concept of patient blood management (PBM) is underrepresented, so the contribution that laboratory diagnostics can make needs to be elucidated. Methods: The central objective of this study was to decrease the volume of blood drawn for laboratory diagnostics as part of a hospital quality management project focussed on increasing efficiency and reducing the turnaround time (TAT) of laboratory results. Optimization potential within the complete preanalytical process was reviewed to obtain potential improvement measures. These measures fell into two groups: training to reduce preanalytical errors in the entire hospital and using blood collection tubes with lower nominal fill volumes. Results: A validation of the success of these measures was performed after 1 year. The occurrence of several blood collection non-compliances had decreased substantially. By changing the blood collection tube volume, approximately 177 L less patient blood was drawn for diagnostic purposes in the 384-bed hospital per year. For geriatric and intensive care unit (ICU) patients, there was a very significant reduction in diagnostic blood loss (−27.2% ICU, −42.5% geriatric patients). The number of tubes used per patient per day decreased by 13%. Conclusions: In conclusion, this approach represents an important lab-side contribution to PBM concepts.

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