A new technique, tested at Sinai Hospital of Baltimore and Massachusetts General Hospital in Boston, limits the loss of blood in patients who can afford blood loss the least -- those in a hospital's intensive care unit.
Bedside blood preservation -- a concept developed by Dr. Bart Chernow, physician-in-chief at Sinai Hospital -- involves use of portable microchemistry instruments, which his research team found allow doctors to evaluate urgent blood test results rapidly and reliably using only two drops of blood.
"The technique may markedly decrease doctor-caused blood loss and, in turn, the fear of possible transfusion-induced viral infections, including AIDS and hepatitis," Chernow said.
A report on the study, involving 850 patients over a one-year period, was published today in JAMA, the Journal of the American Medical Association.
The new analytic methods and instruments have been commercially available for about five years but have not been evaluated sufficiently in acute-care settings to determine the accuracy and utility of the "bedside laboratory," Chernow said.
But, his team has shown it is possible to perform critical diagnostic blood tests on two drops of blood -- instead of multiple tubes -- in less than 70 seconds.
Chernow said he believes the technique could be used to spare patients from needless blood loss in other areas of hospitals, such as emergency departments, operating rooms, and in neonatal and pediatric services.
Chernow, an authority on critical-care medicine -- the care of patients in intensive care, burn, trauma and coronary care units -- said he sees the technique as a major clinical advance.
The Sinai physician recently was appointed editor-in-chief of the journal, Critical Care Medicine.
In the study, blood samples were selected randomly and analyzed from 291 patients at Massachusetts General Hospital and 557 at Sinai.
The analyses were performed during normal requests for blood tests by the patients' physicians.
The tests at the bedside were done virtually simultaneously with traditional clinical laboratory tests and the results appeared to be just as accurate.
Chernow, a professor of medicine at the Johns Hopkins University School of Medicine, came to Baltimore last year from Boston, where he was an associate professor at the Harvard Medical School.
He was also an attending physician and director of the Henry K. Beecher Memorial Research Laboratories at Massachusetts General Hospital.