Iatrogenic anemia: Let’s Save Some Blood

Our curiosity is what drove is to our respective fields in medicine. As an intensivist, I LOOOOVE trending numbers and analyzing the minutia of the details to predict in what direction my patient is going. There is a difference, though, between utilizing labs to better serve your patient and using labs to satisfy your academic curiosity. I admit that I have been guilty of this and still am at times, but it’s something we should definitely work on. We should not be blindly ordering labs and having the vampires come in the middle of the night sucking blood out just because we like to look at numbers in the morning, but rather because it’s providing value to our patients. This causes iatrogenic anemia.

Are we going to make a specific decision based on that or are we just going to be looking at a mostly pointless white count (while ignoring the bands)? This study was published last night. It’s worth a read and it’s free! But it should put front and center in the minds of all my colleagues in training as well as nurses to think “why am I ordering this lab and what am I going to do with the result differently that what I’m doing right now?”. We can save a ton of money for our broke healthcare system, save the patients from the morbidity of a ton of needle sticks, and save our patients from the undeniable anemia that they will eventually fall into. Iatrogenic anemia is not just something else that they need to recover from at the end of the day. As always, a hat tip to the authors.

Whitehead NS, Williams LO, Meleth S, Kennedy SM, Ubaka-Blackmoore N, Geaghan SM, Nichols JH, Carroll P, McEvoy MT, Gayken J, Ernst DJ, Litwin C, Epner P, Taylor J, Graber ML. Interventions to prevent iatrogenic anemia: a Laboratory Medicine Best Practices systematic review. Crit Care. 2019 Aug 9;23(1):278. doi: 10.1186/s13054-019-2511-9. PMID: 31399052; PMCID: PMC6688222.
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