Prevention and management of diagnostic blood loss in critically ill patients:a summary of best evidence
10.3969/j.issn.1671-8283.2025.09.010
- VernacularTitle:成人重症患者诊断性失血预防及管理的最佳证据总结
- Author:
Wei WU
1
;
Haiyan HUANG
;
Yuanyuan MI
;
Jinkai LUO
;
Yanhong JIN
;
Ting YOU
Author Information
1. 华中科技大学同济医学院附属协和医院重症医学科,湖北 武汉,430022
- Publication Type:Journal Article
- Keywords:
intensive care unit;
diagnostic blood loss;
critical care;
evidence summary;
evidence-based nursing
- From:
Modern Clinical Nursing
2025;24(9):75-83
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically retrieve,evaluate and summarise the best available evidence on prevention and management of diagnostic blood loss in critically ill adult patients and to provide guidance for standardising diagnostic blood sampling in clinical practice.Methods A structured evidence question was created using the PIPOST framework(Population,Intervention,Professional,Outcome,Setting and Type of evidence).Guided by the"5S"levels-of-evidence pyramid,a top-down systematic search was conducted on databases of BMJ Best Practice,UpToDate,the Joanna Briggs Institute(JBI)EBP Database,GIN,SIGN,RNAO,NICE,Medlive Guideline,WHO,National Blood Authority(Australia),National Health Commission of China,Cochrane Library,PubMed,EMbase,CINAHL,Web of Science,Wanfang Data,CNKI,VIP,and SinoMed.Searched literature included clinical decision aids,guidelines,evidence summaries,systematic reviews Meta analysis,RCTs,quasi-experimental,cross-sectional,cohort studies and expert consensus/opinions.Search period covered between 1st January 2015 and 10th February 2025.Quality appraisal,evidence extraction,synthesis and grading were performed according to JBI and GRADE approaches.Results Nineteen articles were retrieved including five guidelines,five systematic reviews,one RCT,two quasi-experimental studies,two cross-sectional studies,one professional standard and three expert consensuses.A total of 26 recommendations were extracted and they were organised into five domains:education and training,blood-sampling assessment,frequency of sampling,strategies to minimise blood volume drawn,and quality control.Conclusion This evidence summary provides the best current guidance for preventing and managing iatrogenic blood loss caused by diagnostic testing in critically ill adults,providing evidence-based basis for standardizing blood tests by medical staff.
