Health Day Reporter
Tuesday, April 7, 2015 (HealthDay News)- heart New studies show that surgical patients often undergo dozens of blood tests during hospitalization and can lose more than 0.5 liters of blood over time.
Blood tests are usually done in IV, so patients may not be aware that they are losing so much blood. However, the authors of the study, “surprised by the degree of phlebotomy,” write that blood loss can lead to extended hospital stays.Blood loss is blood transfusion anemia, The researchers suggested, requiring more treatment and higher costs.
Dr. Milo Engolen, a professor of anesthesiology at the University of Michigan Health Systems, said: The good news is that there is a solution and the hospital can take action to protect the patient.
The survey results are published in the March issue of. Annual report of thoracic surgery.. Engolen wrote an editorial accompanying the same issue of the magazine.
Dr. Adam Salisbury, an interventional cardiologist at the St. Luke’s Central American Cardiovascular Institute in Kansas City, is a blood test that allows doctors and nurses to monitor a variety of physical functions for anyone in the hospital. He said he knew about widespread use.
In patients with heart disease, blood tests can help determine if the drug is working. The test also allows doctors to monitor blood gases such as oxygen and carbon dioxide during surgery when the patient breathes through a ventilator, Salisbury, who was not involved in the new study, explained. ..
But how many blood tests are there too many? Dr. Colleen Koch and colleagues at the Cleveland Clinic followed up a cardiac surgery patient for 6 months in 2012. They followed approximately 1,900 patients who were hospitalized once and 27 patients who were hospitalized twice.
Researchers found that each patient underwent an average of 115 blood tests. The median blood drawn from the patient was 454 milliliters. It’s almost 0.5 liters-about 17 ounces.
According to the authors of the study, those who had more complex surgery had more blood tests. And people who have lost more blood tend to stay in the hospital longer and need more blood transfusions.
Salisbury said the high number of blood tests is evidence of a hospital routine that requires daily blood draws “even if they don’t have the questions they are answering.”
“Hospitals need to be aware that this is a problem and as a provider we need to promote these protocols to limit the amount of blood loss,” he said.According to Salisbury, his own study showed that more blood draws lead to more cases of “nosocomial infections”. anemia -Lack Red blood cells It can be serious. Older women are particularly vulnerable to this, he said.
Both Salisbury and Engolen said it was difficult to tell if a person with heart disease had too many blood tests. They said it was necessary for doctors to drive change.
According to Salisbury, the solution involves reducing the number of blood draws per day. Instead of requiring patients to receive more blood draws per day for a variety of purposes, he said, one blood draw can be used for a series of tests at once.
Another solution is to use a “blood storage” device that returns blood to the body when it is taken for testing, Engolen said. This reduces the amount of “waste” blood that isn’t used in the test, he said.
Fewer tests can also reduce costs. “Hospitals may charge a lot of money for these tests, but the marginal cost of each test to the hospital is relatively low,” Engoren said. “But they can sum.”
He pointed out that the greater cost is the blood needed for transfusions to replace the missing blood. “Hospitals typically pay $ 200 to $ 300 per unit to the supplier,” Engoren said. A new study found that patients with heart disease can lose 1-2 units of blood on a blood test during hospitalization.
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Source: Adam Salisbury, MD, Interventional Cardiologist, Saint Luke’s Mid-America Heart and Vascular Institute, Kansas City, Missouri. Professor of Anesthesiology, University of Michigan Health Systems, Ann Arbor, Michigan, Doctor of Medicine, Miro Engolen. March 2015, Annual report of thoracic surgery
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