autotransfusion in massive haemothorax

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Dear all,

Autotransfusion in massive haemothorax is a common procedure in war surgery.
So common, in fact, that in field hospitals of the International Committee
of the Red Cross we have sterilised glass bottles for collection of blood
ready in the OT.

We have used bottles, urine bags (without a no-return valve), and ordinary
blood transfusion bags.

Personally, I have used dextrose-citrate anticoagulant, heparin, or nothing
at all. It does not seem to make a difference. Colleagues from around the
world who have used autotransfusion under combat conditions also do not seem
to notice a difference if anticoagulant is used or not. What everyone agrees
on is the need to pass the collected blood through a filter, usually a
simple gauze compress.

Whatever complications might occur from microparticulate matter etc. are
outweighed by the benefits. Of course, I am talking about massive
haemothorax, not a piddling few hundred ml.

I am certain that a good deal more use can be made of this simple technique
in civilian trauma practice.

--
chris giannou

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