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Intraoperative autotransfusion: an underutilized technique

J L Glover, R Smith, P Yaw

    Surgery
    |October 1, 1976
    PubMed
    Summary
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    Intraoperative autotransfusion (IAT) is underutilized despite evidence showing it is safe and effective. This technique, even with contaminated blood, did not increase morbidity or mortality in surgical patients.

    Area of Science:

    • Medical Science
    • Surgical Innovation
    • Patient Blood Management

    Background:

    • Intraoperative autotransfusion (IAT) use is limited in hospitals, despite increased interest with commercial equipment availability.
    • The study details a transition from sporadic to regular IAT use since 1972, averaging over ten cases monthly.

    Purpose of the Study:

    • To evaluate the safety and efficacy of intraoperative autotransfusion (IAT) in a large patient cohort.
    • To address concerns regarding anticoagulation and blood effects that contribute to the underutilization of IAT.

    Main Methods:

    • The study involved 47 patients undergoing elective vascular operations and 141 undergoing emergency operations, primarily for trauma.
    • The autotransfusion system (ATS) reservoir was heparinized, and the machine was operated by a technician.

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    Main Results:

    • No increase in morbidity or mortality was observed in patients undergoing IAT, including seven trauma patients who received blood contaminated with intestinal contents.
    • Patients survived severe injuries without complications attributable to the autotransfusion procedure.

    Conclusions:

    • Concerns about anticoagulation and blood effects are not valid reasons for the underutilization of intraoperative autotransfusion (IAT).
    • Despite administrative requirements for implementation and managing coagulopathy, IAT is justified in cases requiring two or more units of blood transfusion.