Intraoperative autotransfusion in blunt abdominal trauma

We have used intraoperative autotransfusion in three cases of massive intraabdominal hemorrhage following blunt trauma. Based on this experience we recommend that: (1) To prevent sudden collapse the abdomen should be decompressed slowly through a small incision while blood is collected into the autotransfusion reservoir; (2) A skilled person is required to operate the autotransfusor; and (3) To prevent consumption coagulopathy, autotransfusion must be supplemented by the use of blood components, especially fresh frozen plasma.