Related Experiment Videos
Autotransfusion of potentially culture-positive blood (CPB) in abdominal trauma: preliminary data from a prospective
V Ozmen1, N E McSwain, R L Nichols
1Department of Surgery, Tulane University School of Medicine, New Orleans, LA 70112.
Abstract:
Increased use of autotransfusion for traumatic hemorrhage may reduce amounts of banked blood needed for severe injuries. Autotransfusion is standard for traumatic hemothorax, but has been limited for abdominal injuries. This prospective study used microbiologic data from 152 patients with intestinal injuries. Where anticipated blood loss was greater than 1,000 mL, blood from the peritoneal cavity was cultured, washed, concentrated, and recultured before reinfusion. Infection rates were stratified using the Penetrating Abdominal Trauma Index (PATI). Fifty patients with PATI greater than 20 who received banked blood (group I) (mean: 1,800 mL) were compared with 20 patients (group II) who received autotransfused, potentially culture-positive blood (CPB) (mean: 3,900 mL). Wound infection rates were identical in both groups (25%). No statistically significant increase was found in site-specific infection risk when severity of injury was stratified according to PATI. Bacteremias, pulmonary infections, and urinary infections were not caused by bacteria cultured from autotransfused blood. We conclude that washed CPB may be autotransfused without significantly increased risk of infection in patients with severe abdominal injuries.
Insights
Autotransfusion of potentially culture-positive blood (CPB) is safe for severe abdominal injuries. Washed CPB did not increase infection risk compared to banked blood in patients with intestinal injuries.
Area of Science:
- Trauma Surgery
- Transfusion Medicine
- Infectious Disease
Background:
- Autotransfusion can reduce banked blood needs in trauma.
- Its use in abdominal injuries is limited due to infection concerns.
- Washed autotransfused blood may be a viable alternative.
Purpose of the Study:
- To evaluate the safety of autotransfusing potentially culture-positive blood (CPB) in patients with severe abdominal injuries.
- To compare infection rates between banked blood and washed CPB recipients.
Main Methods:
- Prospective study of 152 patients with intestinal injuries.
- Blood from the peritoneal cavity was cultured, washed, concentrated, and reinfused if anticipated blood loss > 1,000 mL.
- Infection rates stratified by Penetrating Abdominal Trauma Index (PATI) and compared between banked blood and CPB groups.
Main Results:
- Wound infection rates were identical (25%) in both banked blood and CPB groups.
- No significant increase in site-specific infection risk was observed with CPB, even in severe injuries (PATI > 20).
- Bacteremias, pulmonary, and urinary infections were not linked to bacteria in autotransfused blood.
Conclusions:
- Washed, potentially culture-positive blood (CPB) can be safely autotransfused in severe abdominal injuries.
- This practice does not significantly increase infection risk compared to banked blood.
- Autotransfusion of washed CPB is a safe option for managing hemorrhage in abdominal trauma.