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[Autotransfusion, with blood drained from a hemothorax, using the ConstaVac device]
P Lassié1, F Sztark, M E Petitjean
1Département des urgences, Hôpital Pellegrin, Bordeaux.
The technique of autotransfusion with blood drained from a haemothorax has been described nearly 80 years ago. The shed blood is easy to collect and is incoagulable. This technique as two indications: lifesaving autotransfusion in the prehospital phase and blood saving and/or transfusional safety at hospital arrival. This prospective study assessed its value as well as the advantages and disadvantages of the ConstaVac system in 30 patients suffering from haemothorax. This apparatus consists of a 800 mL collecting reservoir on a support equipped with an electric aspirator and a battery. The collected blood is transferred into a reinfusion bag while remaining in a closed circuit. The retransfused volume was 685 +/- 430 mL, representing 80% of the collected volume. The retransfusion took place in less than four hours. The patients with an isolated haemothorax did not receive any homologous blood. Only one technical problem occurred, related to the excessive volume of the haemothorax. The shed blood has decreased content of platelets, fibrinogen, and is incoagulable. Moreover, it is hemolyzed. Its hematocrit is lower than the patient's one. On the other hand, the concentration of 2,3 DPG remains normal. These modifications have no detrimental consequences on the patients as long as the autotransfused volume does not exceed two litres. Infectious problems are rare. Handling requires strict asepsis. The ConstaVac system is marketed for postoperative autotransfusion. It is compact, self-contained and very easy to use. It is the only system able of ensuring blood drainage and retransfusion simultaneously, without requiring any opening of the circuit.(ABSTRACT TRUNCATED AT 250 WORDS)
The technique of autotransfusion with blood drained from a haemothorax has been described nearly 80 years ago. The shed blood is easy to collect and is incoagulable. This technique as two indications: lifesaving autotransfusion in the prehospital phase and blood saving and/or transfusional safety at hospital arrival. This prospective study assessed its value as well as the advantages and disadvantages of the ConstaVac system in 30 patients suffering from haemothorax. This apparatus consists of a 800 mL collecting reservoir on a support equipped with an electric aspirator and a battery. The collected blood is transferred into a reinfusion bag while remaining in a closed circuit. The retransfused volume was 685 +/- 430 mL, representing 80% of the collected volume. The retransfusion took place in less than four hours. The patients with an isolated haemothorax did not receive any homologous blood. Only one technical problem occurred, related to the excessive volume of the haemothorax. The shed blood has decreased content of platelets, fibrinogen, and is incoagulable. Moreover, it is hemolyzed. Its hematocrit is lower than the patient's one. On the other hand, the concentration of 2,3 DPG remains normal. These modifications have no detrimental consequences on the patients as long as the autotransfused volume does not exceed two litres. Infectious problems are rare. Handling requires strict asepsis. The ConstaVac system is marketed for postoperative autotransfusion. It is compact, self-contained and very easy to use. It is the only system able of ensuring blood drainage and retransfusion simultaneously, without requiring any opening of the circuit.(ABSTRACT TRUNCATED AT 250 WORDS)