A comparative study of heel-stick devices for infant blood collection
B. Paes, M. Janes, P. Vegh, F. LaDuca and M. Andrew
Department of Pediatrics, McMaster University Medical Centre, Hamilton, Ontario, Canada.
OBJECTIVE--To evaluate two heel-stick devices by comparing the volume of
blood collected, blood sampling time, amount of hemolysis, pain inflicted
during the procedure, and extent of bruising. DESIGN--Randomized trial.
SETTING--Primary care center in a tertiary-level perinatal hospital.
PARTICIPANTS--Forty healthy, full-term newborns with a postnatal age of
greater than 24 hours. Newborns were fed no more than 1 1/2 hours before
blood sample collection and fulfilled the requirement for routine
phenylketonuria and thyroid screening. INTERVENTIONS--Newborns were
allocated to a single stab with either an automated incision or a lancet
puncture device. MEASUREMENTS/MAIN RESULTS--The total volume of blood and
blood sampling time were significantly better with the automated incision
device (P < .001). Hemolysis was also reduced with the automated
incision device (P < .03). Plasma hemoglobin levels were below 1.0 g/L
in all samples obtained with the automated incision device and in 71% of
samples obtained with the lancet device. There were no differences in the
extent of bruising or in pain symptoms manifested by mean increases in
heart rate and percentage of time crying during the procedure.
CONCLUSIONS--The larger volume of blood obtained within a shorter period
for blood collection and reduced hemolysis with the automated incision
device make it a preferred instrument for neonatal blood collection.
