{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:15:58Z","timestamp":1789402558419,"version":"build-2803163510"},"reference-count":19,"publisher":"Scientific Scholar","issue":"02","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Lab Physicians"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\nBackground\u2003Central venous access devices (CVAD) are an essential part of safe practices in critical care, which enable effective venous access and help in avoiding repeated venipuncture. Discard method is widely practiced for blood sampling. A single occasion of blood sampling may cause minimal blood loss; however, the cumulative volume sequential sampling may become clinically signi\ufb01cant. The study aims to reduce diagnostic blood loss, ensuring that the subsequent blood sample is not diluted or contaminated by residual intraluminal \ufb02uid.<\/jats:p><jats:p>\nPatients and Methods\u2003Within-subjects comparative design was adopted for 64 adult patients in the medical intensive care unit of a tertiary hospital. Two blood samples, using 3 mL and 5 mL discarded volume methods, were collected from each patient. Six serum parameters were measured on each of the paired samples and compared.<\/jats:p><jats:p>\nStatistical Analysis Used\u2003Paired t-test and Wilcoxon signed rank test were used for comparing the two methods. Bland\u2013Altman plot analysis and intraclass correlation were used for clinically meaningful analysis.<\/jats:p><jats:p>\nResults\u2003When tested for fixed bias, there is no statistically significant difference between the methods. Potassium and creatinine levels showed significant proportional bias. The agreement limits of sodium, potassium, creatinine, and direct bilirubin were outside the clinically accepted interval, but the proportion of samples outside these intervals was less than 10%. All serum parameters showed excellent reliability, except for sodium which demonstrated good reliability.<\/jats:p><jats:p>\nConclusions\u2003The practice of discarding 3 mL of blood for discard method is suggested, instead of the standard 5 mL to reduce iatrogenic blood loss. Thus, nurses in critical care are uniquely positioned to limit the diagnostic blood loss while obtaining blood samples.<\/jats:p>","DOI":"10.1055\/s-0041-1726669","type":"journal-article","created":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T23:31:39Z","timestamp":1623972699000},"page":"112-117","source":"Crossref","is-referenced-by-count":14,"title":["Performance of 3 mL versus 5 mL Discarded Volume for Blood Sampling from Central Venous Access Device"],"prefix":"10.25259","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8646-5890","authenticated-orcid":false,"given":"HT","family":"Lalthanthuami","sequence":"additional","affiliation":[{"name":"Department of Medical Surgical Nursing, College of Nursing, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MJ","family":"Kumari","sequence":"additional","affiliation":[{"name":"College of Nursing, JIPMER, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Venkateswaran","sequence":"additional","affiliation":[{"name":"Department of Medicine, JIPMER, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PR","family":"Lakshmi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, JIPMER, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Ramamoorthy","sequence":"additional","affiliation":[{"name":"College of Nursing, JIPMER, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1002\/pbc.20873","article-title":"A study to determine the minimum volume of blood necessary to be discarded from a central venous catheter before a valid sample is obtained in children with cancer","volume":"48","author":"M Cole","year":"2007","journal-title":"Pediatr Blood Cancer"},{"issue":"01","key":"ref3","first-page":"S87","article-title":"Infusion therapy: standard of practice in blood sampling from CVAD","volume":"39","author":"Infusion Nursing Society","year":"2016","journal-title":"J Infus Nurs"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1097\/00044067-199605000-00010","article-title":"Nursing strategies to minimize blood loss associated with phlebotomy","volume":"7","author":"Z F Dech","year":"1996","journal-title":"AACN Clin Issues"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1111\/jth.12831","article-title":"Iatrogenic anemia\/twenty-five million liters of blood into the sewer: comment","volume":"13","author":"K LM Coene","year":"2015","journal-title":"J Thromb Haemost"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1188\/12.CJON.454-458","article-title":"Determining the minimum discard volume for central venous catheter blood draws","volume":"16","author":"S Wyant","year":"2012","journal-title":"Clin J Oncol Nurs"},{"issue":"04","key":"ref7","first-page":"671","article-title":"Horne MK III. 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