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This article is part of the supplement: Anemia in Critical Care: Etiology, Treatment and Prevention .

Review

Phlebotomy in the intensive care unit: strategies for blood conservation

Philip S Barie email

Professor, Departments of Surgery and Public Health, Division of Critical Care and Trauma, Weill Medical College of Cornell University; Anne and Max A Cohen Surgical ICU, New York-Presbyterian Hospital–Weill Cornell Medical Center, New York, New York, USA

author email corresponding author email

Critical Care 2004, 8(Suppl 2):S34-S36doi:10.1186/cc2454

Published: 14 June 2004

Abstract

The quality and economy of critical care could both be improved if blood losses due to phlebotomy and sampling from indwelling catheters for unnecessary diagnostic testing were curtailed. Practice guidelines can help to break bad diagnostic 'habits', such as fever work-ups that require substantial blood to be drawn yet typically yield little useful information. Invasive hemodynamic monitoring is associated with morbidity due to blood loss as well as infection, and newer noninvasive technologies should be encouraged. Several devices allow blood that would otherwise be wasted during sampling to be returned to the patient aseptically. Point-of-care testing uses microliter quantities of blood, has acceptable precision, and can provide valuable diagnostic information while being minimally invasive.


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