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PubMed2001

Treatment of porphyria cutanea tarda with phlebotomy in a patient on peritoneal dialysis.

Porphyria cutanea tarda (PCT) is frequently described among patients with chronic renal failure undergoing hemodialysis. One patient who was receiving peritoneal dialysis and had PCT develop has been described in the literature. However, it was later determined that the patient's PCT was related to the hepatotoxic drug she was receiving rather than her peritoneal dialysis. Our patient is the first reported case, to our knowledge, of a patient with end-stage renal disease with negative hepatitis serology who was not receiving a hepatotoxic drug, or on hemodialysis, who had PCT develop while receiving peritoneal dialysis.

Biopsy, Needle↗
PubMedDate not supplied

The response of various hematologic parameters in the young bovine subjected to multiple phlebotomies.

Specific guidelines for the optimal collection of blood from calves maintained as donors do not exist. This investigation was conducted to document erythrocytic changes in calves subjected to controlled blood loss. Two groups of Holstein calves ranging in age from 2 to 5 months were compared. Six animals were designated controls and six were subjected to a series of three blood collections over an 8 day period. Each collection was roughly 50% of the total circulating blood volume (30 ml/kg of body weight). Hematologic values were compared for 18 days. All calves survived the study. There was no significant difference in circulating cortisol levels or growth rate between groups. Packed cell volumes (PCVs) for the phlebotomized group did not return to original levels during the monitoring period (initial 36%, final 26%), but were within normal limits at 30 days. All phlebotomized calves had a high reticulocyte count (0% control, 11% phlebotomized). Reticulocytes were not observed until the PCV fell below 20. HbF to HbA ratios were a sensitive and acute indicator of accelerated erythropoiesis. Variant ratios stabilized within 18 days. Other parameters compared were red cell indices, total erythrocyte count, total leukocyte count, total plasma protein, total hemoglobin values, and neutrophil to lymphocyte ratios.

Age Factors↗
PubMedDate not supplied

Hemolysis in needleless connectors for phlebotomy.

Needleless connectors have been developed recently as a means of reducing transmission of AIDS and other blood-borne diseases by accidental needle sticks. However, the potential for hemolysis induced by fluid stresses within the connector remained to be determined. The influence of needleless connectors on hemolysis was evaluated in simulated clinical blood draws. Blood from five volunteers was drawn with vacuum tubes and syringes through 16, 18, and 22 gauge needles and PosiFlow (Becton Dickinson, Franklin Lakes, NJ) and Clave (ICU Medical, San Clemente, CA) needleless connectors. Hemolysis was measured in the samples by a spectrophotometric technique. Results showed that hemolysis increased when needleless connectors were used. The PosiFlow connector produced more hemolysis than the Clave device. Curiously, erythrocyte damage was greatest for connectors used with 18 gauge needles. Hemolysis was larger for samples drawn with vacuum tubes than with syringes. However, no combinations of connector, needle size, or blood draw device resulted in mean hemolysis values large enough to interfere with clinical assays.

Erythrocytes↗
PubMed1999

Phlebotomy techniques in the home.

The discussion covers venipuncture from the first stage of choosing the correct needle and collection tube through documentation. Remember that each situation is different. Adaptations must be made for each individual patient and nurse. The information in this article is a guide, and each nurse will modify these techniques to suit his or her own individual style. Good hunting!

Community Health Nursing↗