Iatrogenic anemia and blood conservation strategy of patients in RICU

Abstract

Objective To investigate the relationship of iatrogenic anemia and diagnosis blood loss for patients in RICU,and the change of the anemia before and after the optimized phlebotomy.Methods A prospective study was performed including 69 patients in RICU who met the inclusion criteria during January 2011 to May 2012.The patients adopted from January 2011 to July 2011 were assigned into control group (n =37) and from August 2011 to May 2012 were assigned into observation group (n =32).The control group received the conventional phlebotomy,while the observation group received optimized blood collection method aimed at reducing the blood loss volume respectively.Results In the control group the number of patients with anemia at the 7th day was more than that of the 1st day (23 vs 6 ; x2 =16.388,P =0.000) ; there was difference in Hbd1,Hbd3,Hbd7 (P ＜ 0.05) ; the mean daily phlebotomy volume of the first three days was greater than that of the last four days (P ＝ 0.000) ; Hbc1-3 and Hbc1-7 wcre related with BLd1-3,Hbc4-7 was related with BLd4-7 (P ＜0.05) ; BLd1-3,BLd4-7,BLd1-7 were related with APACHE Ⅱ score positively (P ＜ 0.05).In observation group there was no difference in the proportion of patients with anemia between the 7th day and the 1st day (19 vs 14 ;x2 =1.564,P =0.211); Hbd1,Hbd3 and Hbd7 were no difference (P ＞0.05); the average daily blood loss volume of the first three days was greater than that of last four days (P ＜ 0.05) ; Hbc1-3,Hbc4-7,Hbc1-7 were not related with BLd1-3,BLd4-7 and BLd1-7 (P ＞ 0.05).BLd1-3,BLd4-7 and BLd1-7 were unrelated with APACHE Ⅱ scores (P ＞ 0.05).BLd1-3,BLd4-7,BLd1-7,Hbc1-3,Hbc1-7 in the control group were greater than those of the observation group (P ＜ 0.05) ; there was no difference in Hbc4-7 between the two groups (P ＞ 0.05).Conclusions Diagnostic blood loss can cause the iatrogenic anemia of patients in RICU,and optimizing the blood collection method and enhancing blood conservation can reduce the incidence of iatrogenic anemia. Key words: Intensive care; Iatrogenic anemia; Diagnosis blood loss ; Blood conservation