Autotransfusion in low-resource settings: a scoping review

Area of Science:

• Medical Sciences
• Public Health
• Surgical Innovation

Background:

• Hemorrhage is a leading cause of maternal mortality and preventable trauma death globally.
• Access to safe and sufficient blood transfusions is limited in low-resource settings (LRS).
• Autotransfusion (AT), using a patient's own blood, is an alternative but advanced systems dominate.

Purpose of the Study:

• To review and consolidate information on the current use of basic autotransfusion (AT) in low-resource settings (LRS).
• To identify basic AT techniques and devices described for application in LRS.
• To assess the existing evidence base for basic AT in LRS.

Main Methods:

• A systematic scoping review was conducted.
• Searched PubMed, Web of Science, Global Health, Cochrane Library, and grey literature databases.
• Included studies published after December 31, 2008, detailing basic AT in LRS.

Main Results:

• A paucity of scientific evidence and contradictory information exists regarding the extent of basic AT use in LRS.
• Common indications for basic AT include haemoperitoneum (obstetrics) and haemothorax (trauma).
• Three AT techniques and two new devices/one filter for LRS were identified.

Conclusions:

• Basic AT is practiced for specific indications in LRS, but its safety and effectiveness require context-specific studies.
• The extent of basic AT use is difficult to ascertain, suggesting it is not widely established.
• Further research is needed to overcome barriers to basic AT availability and to evaluate new devices for LRS.