ABSTRACT
Anemia is a common problem in the ICU population. Most patients are anemic at admission, their hemoglobin concentrations declining further thereafter. The aim of the present study was to evaluate the effect of a combination strategy, involving closed arterial blood gas sampling and the use of pediatric vials for phlebotomy [Group A], on the sampling-induced blood loss and the rate of decline in hemoglobin in adult ICU patients. Combination [Group A] was compared to the current standard technique of arterial line sampling and adult vial phlebotomy [Group B] in a prospective, randomised, ethically-approved trial for the first 72 hours of their ICU stay. Peri-operative, oncology, coagulopathic and uremic patients were excluded. All other ICU patients with arterial cannulae and predicted to stay beyond 3 days, were enrolled. 39 patients entered the study, 20 in Group A, and 19 in Group B. Data collection was complete for all. There was a statistically significant difference in sampling-induced blood loss between the groups over the first 72 hours of treatment [mean +/- standard deviation: 15.16 +/- 5.3 ml Group A vs 45.11 +/- 14 ml Group B, p < 0.001]. There was a smaller decline in mean hemoglobin level, which was not statistically significant [0.79 +/- 0.6 g/dL vs 1.30 +/- 1.13, p = 0.09]. Overall, this strategy reduced measurable blood losses from phlebotomy. In larger trials it might also preserve hemoglobin levels