Arterial line blood draw

[RonelA]

Hello to all,
Currently the clinical practice in our NICU is to always return the pre-sample blood, after the sample blood has been obtained from an arterial line. Would appreciate any advice or info re evidence-based reseach in regards to this clinical practice issue.
Thanks! :)
Ronel (NICU RN)

[Stefan Johansson]

Hi!
I think most units would return the pre-sample blood volume. I do not have a good reference at hand, but am certain one would make the infant iatrogenically anemic very soon.
Think about it this way, a tiny premiee may have a total blood volume 50 ml. Most would take a pre-sample blood withdrawal of 1 ml. Throwing away 2% of the total blood volume every time a sample is taken (as often happens several times/24h in a small sick premiee), that infant would need daily transfusions.
There's a similar discussion going on here: http://www.99nicu.org/forum/showthread.php?23797-Pre-sample-blood-volume&highlight=blood+withdrawal
I think you can get some input there as well. Ciao!

[JoannieO]

Hi all,

In our unit we always return the pre-sample blood - our feeling is that we should be taking as little blood as possible to minimise the need for blood transfusions.

[jriley]

We always return pre-sample blood but use a closed system so it is never exposed to air. Really easy to use.