Approximate Iatrogenic Blood Loss in Medical Intensive Care Patients and the Causes of Anemia
Pitima Tosiri MD*, Nonglak Kanitsap MD*, Apichart Kanitsap MD*
Affiliation : * Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Background : Anemia is the most common hematologic problem worldwide especially in developing world. There are many
causes of anemia in ICU patient such as gastrointestinal bleeding, anemia of chronic inflammation, trauma or surgery.
Patient who were admitted in the ICU need to have a lot of blood tests related to their illness and for further treatment, however
that can cause decrease of hematocrit or anemia.
Objective : To identify the estimate volume of blood drawn from medical ICU patients and findout whether the volume of blood
drawn effects the Hemoglobin/Hematocrit (Hb/Hct) or anemia and to identify the cause of anemia in ICU patient.
Material and Method: This is an observation prospective cohort study collecting the volume of blood drawn from patients
who were admitted to ICU Thammasat university hospital during 1st October 2007 through 31st March 2008.
Results : This study found the mean volume of blood samples drawn from ICU patients is 77.8 ml. Sixty-eight percents of
patients had a decrease Hb/Hct level during admission and around sixteen percent had anemia during admission. There is
no statistically significant between the volume of blood drawn and the decrease of Hb/Hct.
Conclusion : Decrease of Hb/Hct or anemia are common in ICU patient. This study showed that iatrogenic blood loss for
laboratory investigation is one of the cause of anemia. We concluded that physician should order phlebotomy for necessary
investigation for the most effective of diagnosis and treatment, but the less complication.
Keywords : Anemia, Iron deficiency anemia, Iatrogenic anemia
