Jakacka Natalia, Snarski Emilian, Mekuria Selamawit
Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Poland.
Adv Clin Exp Med. 2016 Jan-Feb;25(1):191-7. doi: 10.17219/acem/32065.
Iatrogenic anemia caused by diagnostic blood sampling is a common problem in the intensive care unit, where continuous monitoring of blood parameters is very often required. Cumulative blood loss associated with phlebotomy along with other factors render this group of patients particularly susceptible to anemia. As it has been proven that anemia in this group of patients leads to inferior outcomes, packed red blood cell transfusions are used to alleviate possible threats associated with low hemoglobin concentration. However, the use of blood components is a procedure conferring a set of risks to the patients despite improvements in safety. Iatrogenic blood loss has also gained particular attention in neonatal care, where cumulative blood loss due to samples taken during the first week of life could easily equal or exceed circulating blood volume. This review summarizes the current knowledge on the causes of iatrogenic anemia and discusses the most common preventive measures taken to reduce diagnostic blood loss and the requirement for blood component transfusions in the aforementioned clinical situations.
诊断性采血导致的医源性贫血是重症监护病房中的常见问题,该病房常常需要持续监测血液参数。与静脉穿刺相关的累积失血以及其他因素使得这类患者特别容易患贫血。由于已证实这类患者的贫血会导致较差的预后,因此使用浓缩红细胞输血来减轻与低血红蛋白浓度相关的潜在威胁。然而,尽管安全性有所提高,但使用血液成分对患者来说仍是一个存在一系列风险的过程。医源性失血在新生儿护理中也受到了特别关注,在新生儿出生后第一周因采血导致的累积失血很容易等于或超过循环血容量。本综述总结了目前关于医源性贫血病因的知识,并讨论了在上述临床情况下为减少诊断性失血和血液成分输血需求而采取的最常见预防措施。