Impact of Blood Sampling on Anemia in the PICU: A Prospective Cohort Study.
Journal
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
ISSN: 1529-7535
Titre abrégé: Pediatr Crit Care Med
Pays: United States
ID NLM: 100954653
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
pubmed:
12
4
2022
medline:
18
6
2022
entrez:
11
4
2022
Statut:
ppublish
Résumé
Fifty percent of children are anemic after a critical illness. Iatrogenic blood testing may be a contributor to this problem. The objectives of this study were to describe blood sampling practice in a PICU, determine patient factors associated with increased sampling, and examine the association among blood sampling volume, anemia at PICU discharge, and change in hemoglobin from PICU entry to PICU discharge. Prospective observational cohort study. PICU of Sainte-Justine University Hospital. All children consecutively admitted during a 4-month period. Four hundred twenty-three children were enrolled. Mean blood volume sampled was 3.9 (±19) mL/kg/stay, of which 26% was discarded volume. Children with central venous or arterial access were sampled more than those without access (p < 0.05). Children with sepsis, shock, or cardiac surgery were most sampled, those with a primary respiratory diagnosis; the least (p < 0.001). We detected a strong association between blood sample volume and mechanical ventilation (H, 81.35; p < 0.0001), but no association with severity of illness (Worst Pediatric Logistic Organ Dysfunction score) (R, -0.044; p = 0.43). Multivariate analysis (n = 314) showed a significant association between the volume of blood sampled (as continuous variable) and anemia at discharge (adjusted OR, 1.63; 95% CI, 1.18-2.45; p = 0.003). We lacked power to detect an association between blood sampling and change in hemoglobin from PICU admission to PICU discharge. Diagnostic blood sampling in PICU is associated with anemia at discharge. Twenty-five percent of blood losses from sampling is wasted. Volumes are highest for patients with sepsis, shock, or cardiac surgery, and in patients with vascular access or ventilatory support.
Identifiants
pubmed: 35404309
doi: 10.1097/PCC.0000000000002947
pii: 00130478-202206000-00005
doi:
Substances chimiques
Hemoglobins
0
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
435-443Informations de copyright
Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.
Déclaration de conflit d'intérêts
Drs. Sauthier and Du Pont-Thibodeau received funding from Fonds en Recherche du Québec – Santé (FRQS). Dr. Sauthier received support for article research from FRQS. Dr. Du Pont-Thibodeau received funding from the Chaire en médecine transfusionnelle Héma-Québec-Bayer de l’Université de Montréal. The remaining authors have disclosed that they do not have any potential conflicts of interest.
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