AUTOTRANSFUSION
In the western world autotransfusion got a renaissance with the introduction of modern, very sophisticated computerized medical equipment which automatically collects, washes and filters the patient’s own blood during surgery and transfuses it back into the circulation.
In the poor third world we have been using the technique all the time - forced by the circumstances with lack of easy access to blood - in particular banked blood.
The advantage with autotransfused blood is that it is guaranteed compatible, does not expose the patient to contagious diseases from other patients such as malaria and HIV/AIDS, and is administered at the right (body) temperature.
The most common emergencies in which autotransfusion are used is intra abdominal hemorrhage due to either ruptured ectopic pregnancy or a ruptured spleen and intrathoracic bleeding due to trauma – traumatic hemothorax.
Intra abdominal hemorrhage
At laparotomy the blood is collected with a large sterile soup spoon and filtered through several layers of gauze into a sterile bottle. The bottle contains a little citrate added to prevent the collected blood from coagulating (clotting). With this extremely simple and cheap procedure a lot of lives have been saved.
As this woman who arrived in deep shock due to severe intra abdominal bleeding from a ruptured ectopic pregnancy.
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Abdomen distended from the bleeding |
Severe anemia. Picture is taken 10:37 |
To have the equipment ready prepared and sterile is a great advantage
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Blood is removed from the abdominal cavity with a sterile soup spoon, filtered and collected in bottles and then transfused back to the patient.
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If a suitable cork for the glass bottle is not available, the blood can be transferred to sterile empty i.v. bags
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The ruptured ectopic (tubal) pregnancy is grasped, clamped and removed. The pedicle (the tube with the ovarian vessels) is ligated. After that the abdominal cavity is irrigated with saline and closed.
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In the recovery room after surgery |
Anemia reversed. Picture taken at 15:16 |
Intrathoracic bleeding
Due to the constant movements of the beating heart blood in the thoracic cavity will not coagulate. It can easily be collected in a large syringe and reinfused directly into a vein of suitable size.
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