Original articleAdult cardiacContemporary Bloodletting in Cardiac Surgical Care
Section snippets
Material and Methods
From January 1, 2012 through June 30, 2012, 1,894 patients underwent cardiac surgery at Cleveland Clinic, among whom 1,867 had only 1 hospitalization and 27 had 2 (Table 1). Any laboratory testing performed before or after the above dates was excluded from the analysis. Each laboratory test was associated with a name, blood volume, and information on unique accession numbers. An accession number refers to an individual blood drawing event, and therefore multiple (separately identified) tubes
Frequency of Laboratory Testing
A total of 221,498 laboratory tests were performed during the study period, averaging 115 tests per patient. The most frequently performed diagnostic tests were 88,068 blood gas analyses, 39,535 coagulation tests, 30,421 complete blood counts, and 29,374 metabolic panels (Table 2).
Phlebotomy Volume
Total phlebotomy volume differed between the CVICUs and hospital floors, with median cumulative volumes of 332 mL during the CVICU stay and 118 mL on the floors (Table 3). Cumulative median volume for the entire
Comment
We were astonished by both the frequency of testing and cumulative phlebotomy volumes in our cardiac surgical patients. Bloodletting for diagnostic laboratory testing approximates 1 to 2 red blood cell units; for patients in the upper quartile, phlebotomy volumes approached nearly 1 L. Bloodletting to such an extent has consequences, reflected by the subsequent increased need for red blood cell transfusion. Our previous blood conservation efforts have successfully reduced red blood cell use in
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