Emergency autotransfusion

Autotransfusion, a technique with more than 160 years of experience behind it, has become a subject of renewed interest in the emergency setting. The technique itself is not much more difficult than the tube thoracostomy or the peritoneal lavage that otherwise might be indicated in the multiple trauma victim and that would be required to start collection of autologous blood. The previously feared complications of hematologic or metabolic embarrassment and of sepsis have not proved to be of clinical significance when appropriate patient selection and careful technique are followed. In addition the use of autologous blood has a number of advantages over the transfusion of stored homologous blood in the emergency patient, including ready availability of compatible blood, homeostasis of core temperature, higher levels of red blood cell 2,3-DPG, and cost effectiveness. A review of the literature reveals that, while it is not totally free of complications, the benefits to be gained from autotransfusing the selected trauma patient outweigh the relatively limited risks of the procedure.