Decrease seen in RBC units per patient after transition from standard- to small-volume tubes
By Elana Gotkine HealthDay Reporter
MONDAY, Oct. 16, 2023 (HealthDay News) — Use of small-volume blood collection tubes in the intensive care unit (ICU) may decrease red blood cell (RBC) transfusions, according to a study published online Oct. 12 in the Journal of the American Medical Association.
Deborah M. Siegal, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues determined whether transitioning from standard-volume to small-volume vacuum tubes for blood collection in ICUs reduces RBC transfusion in a stepped-wedge cluster randomized trial in 25 adult ICUs in Canada. The ICUs were randomly assigned to transition from standard-volume (10,940 patients) to small-volume (10,261 patients) vacuum tubes for laboratory testing.
The researchers observed no significant difference in RBC units per patient per ICU stay (relative risk, 0.91; 95 percent confidence interval, 0.79 to 1.05). In a prespecified secondary analysis involving 27,411 patients, there was a decrease seen in RBC units per patient per ICU stay after transition from standard- to small-volume tubes (relative risk, 0.88; 95 percent confidence interval, 0.77 to 1.00). The median decrease in transfusion-adjusted hemoglobin did not differ significantly in the primary population and was lower in the secondary population. Before and after the transition, specimens with insufficient quantity for analysis were rare.
“Reducing RBC transfusion, a scarce and costly intervention with well-described risks, is viewed widely as a clinical priority for hospitalized patients,” the authors write. “Although the effects of transitioning to small-volume tubes on RBC transfusion and hemoglobin were modest at the individual patient level, if applied broadly, they could have an impact on hospitals and health systems.”
Several authors disclosed ties to the pharmaceutical industry.
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