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Bleeding Less for Diagnostics

Fred Hashimoto, MD
JAMA. 1982;248(2):171. doi:10.1001/jama.1982.03330020017013.
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To the Editor.—  In centuries past, phlebotomies were performed to treat almost every disease, but in recent times, deliberate bloodlettings have generally been used to obtain samples for diagnostic examinations. Frequently, large volumes of blood have been let, resulting in iatrogenic anemias. Approximately a decade ago in The Journal (1973;223:73), Eyster and Bernene reported that patients in their intensive care units lost an average of 54 mL (SD, 14 mL) of blood per day. They hypothesized that many hospitalized patients would lose between 10% and 20% of their blood volume. To see what progress might have been made in not bleeding patients to illness, we documented blood loss from patients in our medical intensive care unit during one week, observing 59 patient-days. Besides volumes sent to the laboratory, we included in our calculations blood lost during the placement of intravascular lines and blood discarded in obtaining specimens from them. Each


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