let's get small: how blood collection is changing
Phlebotomy (blood draw) is still among the most widely used invasive procedures in healthcare. Despite its myriad useful applications in drug development, diagnostic, treatment monitoring, and disease prevention, traditional blood sampling is not without risks. Even at its best, drawn blood volumes often far exceed the volumes needed for the actual analysis.
How Does Phlebotomy Miniaturization Benefit Partipants?
While rapid technological advancements over the last two decades led to lower collection and analytic volumes of the blood samples, most laboratories still collect larger volumes than are required. The risks associated with venipuncture and large blood sample volumes are the driving force behind the shift toward microsampling (capillary blood) when such sampling alternative can provide reliable and satisfactory test results.
- Reduced Clinical Fragility and In-Hospital Morbidity and Mortality
Phlebotomy is a primary cause of hospital-acquired anemia (HAA or nosocomial anemia), occurring in 41% of patients in pediatric intensive care units and 45% patients aged over 18. A shift toward microsampling, when the clinical status of the patient allows it, reduces the blood loss associated with diagnostic phlebotomy. This significantly lowers the risk of HAA.
- Mitigated Blood Sampling Adverse Events
While not without its own risks, some of which can occur during and after any blood sampling technique (allergic reaction to disinfectant, hematoma formation, nerve damage), capillary blood sampling greatly reduces some of the downsides of venipuncture. In addition to minimizing the risk of iatrogenic (non-hospital setting) and nosocomial anemia, microsampling improves patient experience by reducing anxiety and pain, preventing syncope and fainting, and minimizing the risk of excessive bleeding.
- Increased Patient Compliance
With newer microsampling techniques such as Volumetric Absorptive Microsampling (VAMS™), that circumvent limitations of traditional dried blood sampling techniques (impact of hematocrit, sophisticated sample handling), patients do not need to visit a medical facility for the blood draw. Despite accurate and reproducible sample collection procedure, the use of Mitra microsampler does not require specialized training – chronic patients can self-sample, which facilitates ongoing disease and treatment monitoring. The technique can also be used on-site and in low-resource settings (no need for specialized sample transportation and storage chain), facilitating general population screening.
Although analytical challenges associated with low volume blood samples, as well as minor adverse events of capillary blood draws, are not yet fully overcome, participants are not the only ones that benefit from miniaturization trends in phlebotomy. Dry blood sampling, when performed with reliable microsampling techniques, benefits researchers, medical practitioners, and laboratory personnel just as much.