Mahieu L, Marien A, De Dooy J, Mahieu M, Mahieu H, Van Hoof V. Implementation of a multi-parameter Point-of-Care-blood test analyzer reduces central laboratory testing and need for blood transfusions in very low birth weight infants.
Clin Chim Acta 2011;
413:325-30. [PMID:
22056692 DOI:
10.1016/j.cca.2011.10.027]
[Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 10/19/2011] [Accepted: 10/19/2011] [Indexed: 01/14/2023]
Abstract
Blood sampling for laboratory testing is a major cause of iatrogenic blood loss and anemia in neonatal intensive care unit [NICU] patients. The objective of the study was to assess whether the implementation of a multi-parameter Point of Care Test [POCT] (Roche, Cobas b221) analyzer affected blood loss for central laboratory testing and need for red blood cell transfusion in our NICU. This was a retrospective observational cohort study in a NICU with comparison of two serial cohorts of 2 years each. Implementation of a multi-parameter POCT decreased central laboratory performed testing for bilirubin (-32% per patient) and electrolytes (-36% per patient). On average, the net blood volume taken per admitted patient for electrolyte testing decreased with 23.7% and 22.2% for bilirubin testing in the second cohort. After implementation of POCT, fewer very low birth weight infants [VLBWI] required blood transfusion (38.9% vs. 50%, p<.05) as the number of transfusion/infants decreased by 48% (1.57 vs. 2.53, p<0.01). The implementation of POCT was cost-efficient for the Belgian national health insurance, cost reduction -8.3% per neonate. We conclude that implementation of a bedside multi-parameter POCT analyzer decreases transfusions among VLBWI by reducing iatrogenic blood loss for central laboratory testing.
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