Autotransfusion of hemothorax blood in trauma patients: is it the same as fresh whole blood?

Abstract:

BACKGROUND:Autotransfusable shed blood has been poorly characterized in trauma and may have similarities to whole blood with additional benefits. METHODS:This was a prospective descriptive study of adult patients from whom ≥50 mL of blood was drained within the first 4 hours after chest tube placement. Pleural and venous blood samples were analyzed for coagulation, hematology, and electrolytes. RESULTS:Twenty-two subjects were enrolled in 9 months. The following measured coagulation factors of hemothorax were significantly depleted compared with venous blood: international normalized ratio (>9 in contrast to 1.1, P < .001), activated partial thromboplastin time (>180 in contrast to 28.5 seconds, P < .001), and fibrinogen (<50 in contrast to 288 mg/dL, P < .001). The mean hematocrit (26.4 in contrast to 33.9), (P = .003), hemoglobin (9.3 in contrast to 11.8 g/dL, P = .004), and platelet count (53 in contrast to 174 K/μL, P < .001) of hemothorax were significantly lower than venous blood. A hemothorax volume of 726 mL was calculated to be equivalent to 1 U of red blood cells. CONCLUSIONS:Hemothorax blood contains significantly decreased coagulation factors and has lower hemoglobin when compared with venous blood.

journal_name

Am J Surg

authors

Salhanick M,Corneille M,Higgins R,Olson J,Michalek J,Harrison C,Stewart R,Dent D

doi

10.1016/j.amjsurg.2011.06.043

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

817-21; discussion 821-2

issue

6

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(11)00549-6

journal_volume

202

pub_type

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