Blood collection: For better and for worse

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Blood samples collected from heart patients can lead to anemia.

A new study based in St. Luke?s Hospital, United States of America revealed that when patients go to hospitals due to heart attacks, such a high amount of blood is collected from them that it leads to anemia, only causing a further decline in their health.

Anemia is a condition where a person has a decreased number of blood cells, or a very low level of hemoglobin in the blood, which intern leads to less oxygen being provided to body tissues. This then results in increased fatigue, shortness of breath and other symptoms that can negatively affect and individual?s well-being.

The study

The study was published in the Archives of Internal Medicine

The number of patients analyzed: 17,676

The number of hospitals: 57

Time period: Between 2000 and 2008

Results: The average volume of blood drawn from patients who developed anemia was 173.8 milliliters, more than double the amount of blood draw from patients who do not develop anemia, which was 83.5 milliliters. For every 50 milliliters of blood drawn, the risk of moderate to severe hospital-acquired anemia increased by 18 percent.

All the patients suffered from heart attacks. More precisely, their condition is named acute myocardial infarction (MI) and it was found that those who developed moderate to sever anemia has more blood drawn on each of the first ten days of being hospitalized , and more blood drawn in a 24-hour period that those with mild or no anemia.

On average, blood loss across hospitals ranged from 119 to 246 milliliters. The researchers found that 20% of the patients who did not suffer from anemia when they were admitted to hospitals developed moderate or severe cases of red blood-cell deficiency by the time they left.

And those patients who left the hospital with this disease left with fatigue, shortness of breath and physically weak. For patients who have already had heart attacks, anemia can worsen their health and it is also associated with a higher death rate.

What does this mean for Medical Practice?

Mikhail Kosiborod, is the study?s senior author and an associate professor of medicine at the University of Missouri-Kansas City. He remarked on how doctors would have to change some of the medical procedures they adopt. The major risk factor that has been highlighted by the study, serves as a serious caution that is patients, ?have other medical problems their body can?t regenerate blood cells fast enough.?

1 out 7 beneficiaries of Medicare, the U.S. health program for the elderly and disabled, are victims of adverse, preventable events, such as sickness and infections in hospitals. According to the Department of Health and Human Services this costs up to $4.4 million annually.

Steps for Prevention

Blood Volume

Kosiborod wanted to point out that the study?s findings are not related to medical mistakes, but rather that the amount of blood drawn from patients must be reduced. Therefore, medical professionals need to figure out a way of collecting less blood than they normally do, for laboratory tests.

The usage of smaller tubes and using blood samples that have already been drawn could help hospitals reduce the amount of blood loss, said the professor.

Old Habits Discouraged

?Some doctors indiscriminately take blood tests without consciously asking why they need it and what they?re looking for,? said Stephanie Rennke, an assistant clinical professor at the University of California, San Francisco??and lead author of a commentary article on the anemia study. ?It?s hard to change when they get into the routine of doing things.?

She said, patients should be tested from a single blood sample each day and only tested on the day of discharge if it is absolutely necessary.

Better Nutrition

Proper nutrition to patients who are giving blood tests, could help prevent hospital-acquired anemia, she suggested.

The team wrote that, ?These findings suggest that hospital-acquired anemia may be preventable by implementing strategies to limit blood loss from laboratory testing.? They concluded saying that, ?Studies are needed to test whether strategies that limit both the number of blood draws and the volume of blood removed for diagnostic testing can prevent hospital-acquired anemia and improve clinical outcomes in patients with acute MI.?

Sources: Bloomberg, The Wall Street Journal, Medical News Today

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