Effect of blood sampling management on reducing blood transfusions in very preterm infants

作者：Jingjun Pei, Jun Tang, Yanling Hu, Xingli Wan, Jing Shi, Hua Wang, Qiong Chen, Xiaowen Li, Jian Chen, Chao Chen, Hongju Chen, Junjie Ying, Dezhi Mu · 发表于：Chinese Medical Journal · 年份：2023 · DOI：10.1097/cm9.0000000000002596 · 被引用次数：3 · 研究领域：Neonatal Health and Biochemistry、Neonatal Respiratory Health Research、Neonatal and fetal brain pathology

To the Editor: Unstable clinical conditions and complications make multiple laboratory tests and blood sampling inevitable in preterm infants, contributing to iatrogenic blood loss. Undoubtedly, iatrogenic blood loss is highly correlated with red blood cell transfusion (RBCT). A previous study on extremely low birth weight (BW) infants reported that the sampling blood loss was 30.0 mL/kg within the first week of life, leading to one or more RBCTs in 98% of patients.[1] RBCTs are increasingly reported to cause inflammatory responses and increase the incidence of preterm complications. Therefore, reducing iatrogenic blood loss could not only decrease the need for transfusions but also reduce the risk of neonatal mortality and morbidity. However, clinicians are not sufficiently aware of the risks of frequent sampling. Few studies reported detailed information on sampling blood loss of premature infants during hospitalization and its correlation with gestational age (GA) in preterm infants. Existing measures to reduce sampling blood loss, including staff education, smaller sampling vessels, closed blood sampling devices, and point-of-care testing, have been applied to adults and children in intensive care units (ICUs).[2] However, these measures have not been widely implemented in neonatal ICUs (NICUs). Therefore, we conducted a prospective cohort study on the quality management of blood sampling with historical controls, to evaluate sampling blood loss during hospitalization and...