{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T14:17:51Z","timestamp":1788358671978,"version":"build-2803163510"},"reference-count":14,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,27]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n The aim was to reduce blood loss related to laboratory blood sampling by decreasing the discard blood volume from the central venous catheter (CVC) from 10 to 3\u202fmL, and replacing the 3\u202fmL tube for complete blood count (CBC) with a 2\u202fmL tube. A comparison study was performed, and after introduction of this modified protocol the decrease in withdrawn blood was calculated.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In 52 adult inpatients at the ICU 3\u202fmL of blood was discarded from the CVC, and blood was drawn in a 5\u202fmL serum tube and a 2\u202fmL EDTA tube (test samples), followed by subsequent sampling for routine laboratory testing using the same blood tubes (routine samples). In paired test and routine samples, clinical chemistry testing and CBC were performed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n High correlations (\u03c1>0.90) were obtained for the majority of parameters. Small constant difference was obtained for hemoglobin. Small significant biases were observed for hemoglobin, MCHC, albumin, ALT, calcium, chlorides, MCV and glucose, however, being below the biases of the analytical methods. No statistically significant differences between test and routine samples were found for any of the assessed tests (p>0.05). Implementation of the 3\u202fmL discard blood volume protocol and transition to a smaller volume tube for CBC reduced the amount of withdrawn blood by almost half (46\u202f%).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The 3\u202fmL discard blood volume from the CVC can be safely used for routine hematology and clinical chemistry testing. The dual approach assessed herein can contribute to reduction of iatrogenic blood\u00a0loss.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/dx-2025-0065","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T06:57:34Z","timestamp":1751871454000},"page":"92-99","source":"Crossref","is-referenced-by-count":1,"title":["Minimizing the discard blood volume from the central venous catheter for routine laboratory testing in adult intensive care unit"],"prefix":"10.1515","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0854-4526","authenticated-orcid":false,"given":"Ivana","family":"Lapi\u0107","sequence":"first","affiliation":[{"name":"Department of Laboratory Diagnostics , University Hospital Center Zagreb , Zagreb , Croatia"},{"name":"Faculty of Pharmacy and Biochemistry , University of Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josipa","family":"Kostelac","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Division of Internal Medicine , University Hospital Centre Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luka","family":"Bielen","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Division of Internal Medicine , University Hospital Centre Zagreb , Zagreb , Croatia"},{"name":"School of Medicine , University of Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9374-429X","authenticated-orcid":false,"given":"Ana","family":"Vujaklija Brajkovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Division of Internal Medicine , University Hospital Centre Zagreb , Zagreb , Croatia"},{"name":"School of Medicine , University of Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana","family":"Rup\u010di\u0107 Gra\u010danin","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry Laboratory Diagnostics and Transfusion Medicine , General Hospital and Hospital of Homeland War Veterans Ogulin , Ogulin , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunja","family":"Rogi\u0107","sequence":"additional","affiliation":[{"name":"Department of Laboratory Diagnostics , University Hospital Center Zagreb , Zagreb , Croatia"},{"name":"Faculty of Pharmacy and Biochemistry , University of Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Radovan","family":"Radoni\u0107","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Division of Internal Medicine , University Hospital Centre Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"2026090213592765943_j_dx-2025-0065_ref_001","doi-asserted-by":"crossref","unstructured":"Allyn, J, Devineau, M, Oliver, M, Descombes, G, Allou, N, Ferdynus, C. A descriptive study of routine laboratory testing in intensive care unit in nearly 140,000 patient stays. Sci Rep 2022;12:21526. https:\/\/doi.org\/10.1038\/s41598-022-25961-1.","DOI":"10.1038\/s41598-022-25961-1"},{"key":"2026090213592765943_j_dx-2025-0065_ref_002","doi-asserted-by":"crossref","unstructured":"Barie, PS. Phlebotomy in the intensive care unit: strategies for blood conservation. Crit Care 2004;8:S34\u20136. https:\/\/doi.org\/10.1186\/cc2454.","DOI":"10.1186\/cc2454"},{"key":"2026090213592765943_j_dx-2025-0065_ref_003","doi-asserted-by":"crossref","unstructured":"Baysan, M, Arbous, MS, van der Bom, JG. Iatrogenic anemia: an underestimated and solvable problem in the intensive care unit. Ann Blood 2020;5:19. https:\/\/doi.org\/10.21037\/aob-20-29.","DOI":"10.21037\/aob-20-29"},{"key":"2026090213592765943_j_dx-2025-0065_ref_004","doi-asserted-by":"crossref","unstructured":"Lalthanthuami, HT, Kumari, MJ, Venkateswaran, R, Lakshmi, PR, Ramamoorthy, L. Performance of 3\u00a0mL versus 5\u00a0mL discarded volume for blood sampling from central venous access device. J\u00a0Lab Phys 2021;13:112\u20137. https:\/\/doi.org\/10.1055\/s-0041-1726669.","DOI":"10.1055\/s-0041-1726669"},{"key":"2026090213592765943_j_dx-2025-0065_ref_005","doi-asserted-by":"crossref","unstructured":"Wyant, S, Crickman, R. Determining the minimum discard volume for central venous catheter blood draws. Clin J Oncol Nurs 2012;16:454\u20138. https:\/\/doi.org\/10.1188\/12.cjon.454-458.","DOI":"10.1188\/12.CJON.454-458"},{"key":"2026090213592765943_j_dx-2025-0065_ref_006","doi-asserted-by":"crossref","unstructured":"Chen, K, Kong, W, Liao, C, Liang, Y, Ding, J, Zhu, X, et al.. Comparison of laboratory results between central venous access devices and venipuncture: a systematic review and meta-analysis. J\u00a0Vasc Access 2024;25:1376\u201388. https:\/\/doi.org\/10.1177\/11297298231155522.","DOI":"10.1177\/11297298231155522"},{"key":"2026090213592765943_j_dx-2025-0065_ref_007","doi-asserted-by":"crossref","unstructured":"Odum, L, Drenck, NE. Blood sampling for biochemical analysis from central venous catheters: minimizing the volume of discarded blood. Clin Chem Lab Med 2002;40:152\u20135. https:\/\/doi.org\/10.1515\/cclm.2002.026.","DOI":"10.1515\/CCLM.2002.026"},{"key":"2026090213592765943_j_dx-2025-0065_ref_008","unstructured":"Hrvatska Komora Medicinskih, Sestara. Standardni operativni postupci u zdravstvenoj njezi. Zagreb: Hrvatska Komora Medicinskih Sestara; 2022 [in Croatian]."},{"key":"2026090213592765943_j_dx-2025-0065_ref_009","doi-asserted-by":"crossref","unstructured":"Gorski, LA, Hadaway, L, Hagle, ME, Broadhurst, D, Clare, S, Kleidon, T, et al.. Infusion therapy: standards of practice. J\u00a0Infus Nurs 2021;44:S1\u2013224. https:\/\/doi.org\/10.1097\/nan.0000000000000396.","DOI":"10.1097\/NAN.0000000000000396"},{"key":"2026090213592765943_j_dx-2025-0065_ref_010","unstructured":"Clinical and Laboratory Standards Institute (CLSI). User verification of precision and estimation of bias; approved guideline, 3rd ed. Wayne, PA: CLSI EP15-A3; 2014."},{"key":"2026090213592765943_j_dx-2025-0065_ref_011","doi-asserted-by":"crossref","unstructured":"Cole, M, Price, L, Parry, A, Picton, S, Waters, F, Marshall, S, et al.. 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. Pediatr Blood Cancer 2007;48:687\u201395. https:\/\/doi.org\/10.1002\/pbc.20873.","DOI":"10.1002\/pbc.20873"},{"key":"2026090213592765943_j_dx-2025-0065_ref_012","doi-asserted-by":"crossref","unstructured":"Villalta-Garc\u00eda, P, L\u00f3pez-Herr\u00e1nz, M, Mazo-Pascual, S, Honrubia-Fern\u00e1ndez, T, J\u00e1\u00f1ez-Escalada, L, Fern\u00e1ndez-P\u00e9rez, C. Reliability of blood test results in samples obtained using a 2-mL discard volume from the proximal lumen of a triple-lumen central venous catheter in the critically ill patient. Nurs Crit Care 2017;22:298\u2013304. https:\/\/doi.org\/10.1111\/nicc.12220.","DOI":"10.1111\/nicc.12220"},{"key":"2026090213592765943_j_dx-2025-0065_ref_013","unstructured":"Clinical and Laboratory Standards Institute (CLSI). Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved guideline, 6th ed. Wayne, PA: CLSI GP41-A6; 2007."},{"key":"2026090213592765943_j_dx-2025-0065_ref_014","doi-asserted-by":"crossref","unstructured":"Ranasinghe, T, Freeman, WD. ICU vampirism\u2019\u00a0\u2013\u00a0time for judicious blood draws in critically ill patients. Br J Haematol 2014;164:302\u20133. https:\/\/doi.org\/10.1111\/bjh.12613.","DOI":"10.1111\/bjh.12613"}],"container-title":["Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dx-2025-0065\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dx-2025-0065\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:59:33Z","timestamp":1788357573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dx-2025-0065\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,7,8]]},"published-print":{"date-parts":[[2026,2,27]]}},"alternative-id":["10.1515\/dx-2025-0065"],"URL":"https:\/\/doi.org\/10.1515\/dx-2025-0065","relation":{},"ISSN":["2194-802X"],"issn-type":[{"value":"2194-802X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]}}}