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Small-Volume Tubes to  Reduce Anemia and Transfusion

Learn about the use of small-volume tubes to reduce anemia and transfusion rates in hospitals. Anemia is associated with poor outcomes and high transfusion rates, which can cause harm. This study explores the benefits of using small-volume tubes in blood collection procedures.

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Small-Volume Tubes to  Reduce Anemia and Transfusion

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  1. Small-Volume Tubes to  Reduce Anemia and Transfusion Blood Collection Team Training Slides

  2. Study Rationale

  3. Study Rationale Anemia is a common problem in hospitals

  4. Study Rationale Anemia is a common problem in hospital • Increased 30-day mortality • Longer ICU length of stay • Longer hospital length of stay Anemia is associated with poor outcomes

  5. Study Rationale Anemia is a common problem in hospital • 40% of all ICU patients receive ≥1 RBC transfusions • 75% of patients in ICU for >1 week receive ≥1 RBC transfusion • 50% of transfusions given in absence of any hemorrhage Anemia is associated with poor outcomes Anemia leads to high transfusion rates

  6. Study Rationale Anemia is a common problem in hospital Anemia is associated with poor outcomes Anemia leads to high transfusion rates RBC transfusions cause harm

  7. Anemia can be caused by different factors

  8. Laboratory Testing Causes Blood Loss • 21 mL/day taken in patients with acute MI • 41 mL/day taken in ICU patients • Like losing 1 unit of blood every ~8 days

  9. Small-volume blood collection tubes • Also known as ‘soft-draw’ tubes • Draw 25-50% less blood due to less vacuum • Same cost • Same concentration of anticoagulant • Same physical dimensions • Often routinely used in adults

  10. Study Protocol Overview

  11. Intervention Standard-draw tubes Small-volume tubes Source: BD Lifesciences – Preanalytical Systems, Product Catalogue 2018, Canada

  12. Blood Collection Tubes

  13. Blood Collection Processes If you are not familiar with the institutional guidelines or have any questions, contact your Nurse Educator or the STRATUS Study Research Coordinator at your site.

  14. Small-volume Tubes • Same blood collection procedure as standard-volume tubes • Draw less blood due to less vacuum in the tube • Same ratio of anticoagulant to sample • Tube will automatically fill to the maximum fill volume • The maximum fill-line may be lower than on standard-volume tube • This is demonstrated over the next few slides… Standard-volume tubes in these slides may differ from tubes available at your site. Always refer to the fill-line on the tube label!

  15. How to identify the fill-line? The fill line is indicated on the label

  16. Why fill to the fill-line? Correct test results  Less blood drawn from patients

  17. Citrate (Blue) Tube 1.8 mL tube Small-volume Tube 2.7 mL tube Standard-volume Tube Will be switched to Fill line Fill line Fill Line Etched on Tube

  18. Serum (Red) Tube 4mL tube Standard-volume Tube 2mL tube Small-volume Tube Will be switched to Fill line Fill line

  19. Lithium-heparin (Green) Tube 6 mL tube Standard-volume Tube 2 mL tube Small-volume Tube Will be switched to Fill line Fill line

  20. Barricor (Green) Tube 3mL tube Small-volume Tube 4.5 mL tube Standard-volume Tube Will be switched to Fill line Fill line

  21. PST Gel + Lithium-heparin (Lime-Green) Tube 3.5 mL tube Standard-volume Tube 3mL tube Small-volume Tube Will be switched to Fill line Fill line

  22. Serum Separation (Gold) Tube 2mL tube Small-volume Tube 4mL tube Standard-volume Tube Fill line Will be switched to Fill line

  23. EDTA (Lavender) Tube 4mL tube Standard-volume Tube 2mL tube Small-volume Tube Will be switched to Fill line Fill line

  24. Sodium Fluoride/Na2(Grey) Tube 4mL tube Standard-volume Tube 2mL tube Small-volume Tube Will be switched to Fill line Fill line

  25. Thank you for completing this course! This study is a multi-disciplinary collaborative effort. We appreciate your assistance. Contact your site coordinator or stratus@phri.ca if you have questions on STRATUS!

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