REDUCTION OF BLOOD-LOSS FROM DIAGNOSTIC SAMPLING IN CRITICALLY ILL PATIENTS USING A BLOOD-CONSERVING ARTERIAL LINE SYSTEM

Study objective: To demonstrate the utility of a new blood-conserving arterial line system in reducing blood loss associated with blood draw ing in the critical care setting. Design: Prospective, randomized, cro ssover comparison between two arterial line systems. Setting: Medical intensive care unit (ICU); tertiary care teaching institution. Patient s: Thirty-one patients who required invasive arterial blood pressure m onitoring throughout their ICU course. Interventions: For ICU days 1 t o 2, patients were randomized to receive either a conventional arteria l line system or a new blood-conserving arterial line system. On ICU d ays 3 to 7, patients with a conventional arterial line were crossed ov er to the blood-conserving arterial line, and vice versa. Laboratory b lood volumes, mixed discard volumes, and blood discard volumes were th en recorded to document how much blood loss is associated with each as pect of the blood sampling process. Results: The mean total volume of blood sent to the laboratory for testing was 257.4 ml. As a result of ''clearing the line'' over the 7-day period, patients with the convent ional arterial line system lost a mean volume of 340.2 ml of blood mix ed with heparinized saline solution more than patients with the blood- conserving arterial line. In terms of the blood component of the blood -heparinized saline solution mixture, use of the conventional arterial line was associated with an average of 156.8 ml more blood discarded than with the blood-conserving arterial line. Conclusion: The new bloo d-conserving arterial line system provides a simple and effective meth od for reducing blood loss related to diagnostic sampling in the criti cal care setting.