August 12th, 2011
Podcast 128: Bleeding patients, inadvertently, into anemia happens more often than you might think
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An article in Archives of Internal Medicine examines what’s called “diagnostic blood loss” — the loss of blood through phlebotomy and not hemorrhage. The effect is the same, however.
According to a study conducted in 57 medical centers among some 18,000 patients with myocardial infarction, one in five became moderately or severely anemic (hemoglobin level under 11) from their hospital stay. That’s a 20% rate of iatrogenic anemia. Two of the study’s authors discuss the work and their proposed fixes to this problem, which most likely isn’t limited to patients with MIs.
One Response to “Podcast 128: Bleeding patients, inadvertently, into anemia happens more often than you might think”
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It seems unlikely that the amount of 130ml blood bloss from phlebotomy would lead to such drops in haemoglobin (about 3 to 4 points), given that the total amount of blood should be above 4 liter. Probably there is a confounding factor in that sicker patients may get treatments such as infusions with saline or intensive monitoring on Intensive care units for patients with respiratory failure.
We believe that in our ICU the greatest amount of blood loss is actually from intraarterial access with frequent blood gas controls and discarding about 10ml before every test at 8h intervalls.
The total amount of blood loss for patients here may thous amount to 1 unit of blood for every week!