• Tine François, Michaël Sauthier, Julien Charlier, Jessica Dessureault, Marisa Tucci, Karen Harrington, Laurence Ducharme-Crevier, Sally Al Omar, Jacques Lacroix, and Geneviève Du Pont-Thibodeau.
• Department of Pediatrics, Pediatric Intensive Care Unit, Sainte-Justine University Health Centre, Université de Montréal, Montreal, QC, Canada.
• Pediatr Crit Care Me. 2022 Jun 1; 23 (6): 435443435-443.

ObjectivesFifty percent of children are anemic after a critical illness. Iatrogenic blood testing may be a contributor to this problem. The objectives of this study were to describe blood sampling practice in a PICU, determine patient factors associated with increased sampling, and examine the association among blood sampling volume, anemia at PICU discharge, and change in hemoglobin from PICU entry to PICU discharge.DesignProspective observational cohort study.SettingPICU of Sainte-Justine University Hospital.PatientsAll children consecutively admitted during a 4-month period.Measurements And Main ResultsFour hundred twenty-three children were enrolled. Mean blood volume sampled was 3.9 (±19) mL/kg/stay, of which 26% was discarded volume. Children with central venous or arterial access were sampled more than those without access (p < 0.05). Children with sepsis, shock, or cardiac surgery were most sampled, those with a primary respiratory diagnosis; the least (p < 0.001). We detected a strong association between blood sample volume and mechanical ventilation (H, 81.35; p < 0.0001), but no association with severity of illness (Worst Pediatric Logistic Organ Dysfunction score) (R, -0.044; p = 0.43). Multivariate analysis (n = 314) showed a significant association between the volume of blood sampled (as continuous variable) and anemia at discharge (adjusted OR, 1.63; 95% CI, 1.18-2.45; p = 0.003). We lacked power to detect an association between blood sampling and change in hemoglobin from PICU admission to PICU discharge.ConclusionsDiagnostic blood sampling in PICU is associated with anemia at discharge. Twenty-five percent of blood losses from sampling is wasted. Volumes are highest for patients with sepsis, shock, or cardiac surgery, and in patients with vascular access or ventilatory support.Copyright © 2022 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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