STRATUS will evaluate the use of small-volume ("soft-draw") blood collection tubes for laboratory testing in reducing anemia and transfusion in intensive care unit patients without significant adverse consequences. This is a simple, cost-neutral intervention that could improve the quality of patient care and reduce the harms of frequent laboratory testing.

The STRATUS Pilot Study is a prospective observational study (before-after design) to assess the feasibility of implementing a full-scale randomized trial powered for clinical outcomes (RBC transfusion, incidence and severity of anemia). Identification of barriers and facilitators of implementation will enhance the conduct of the full-scale trial and facilitate incorporation of the intervention into routine practice.

Investigative Site Eligibility:

• Intensive care unit with at least 15 beds with capacity for mechanical ventilation
• Current standard to use standard-draw blood collection tubes
• Availability of hospital administrative data and electronic patient information

All adult patients admitted to the participating intensive care unit at the investigative site.