Division of Trauma and Emergency Surgery, Department of Surgery, University of Texas Health Science Center, San Antonio, TX 78229, USA.
Am J Surg. 2011 Dec;202(6):817-21; discussion 821-2. doi: 10.1016/j.amjsurg.2011.06.043.
Autotransfusable shed blood has been poorly characterized in trauma and may have similarities to whole blood with additional benefits.
This was a prospective descriptive study of adult patients from whom ≥50 mL of blood was drained within the first 4 hours after chest tube placement. Pleural and venous blood samples were analyzed for coagulation, hematology, and electrolytes.
Twenty-two subjects were enrolled in 9 months. The following measured coagulation factors of hemothorax were significantly depleted compared with venous blood: international normalized ratio (>9 in contrast to 1.1, P < .001), activated partial thromboplastin time (>180 in contrast to 28.5 seconds, P < .001), and fibrinogen (<50 in contrast to 288 mg/dL, P < .001). The mean hematocrit (26.4 in contrast to 33.9), (P = .003), hemoglobin (9.3 in contrast to 11.8 g/dL, P = .004), and platelet count (53 in contrast to 174 K/μL, P < .001) of hemothorax were significantly lower than venous blood. A hemothorax volume of 726 mL was calculated to be equivalent to 1 U of red blood cells.
Hemothorax blood contains significantly decreased coagulation factors and has lower hemoglobin when compared with venous blood.
创伤患者自体可输出血液的特征尚未得到充分描述，其可能与全血具有相似性，并具有额外的益处。
这是一项针对成人患者的前瞻性描述性研究，这些患者在放置胸腔引流管后 4 小时内从体内引流出≥50 毫升的血液。对胸腔血和静脉血样本进行凝血、血液学和电解质分析。
在 9 个月的时间里，共纳入了 22 名受试者。与静脉血相比，以下胸腔积血的凝血因子明显减少：国际标准化比值（>9 比 1.1，P<.001）、活化部分凝血活酶时间（>180 比 28.5 秒，P<.001）和纤维蛋白原（<50 比 288 毫克/分升，P<.001）。胸腔积血的平均血细胞比容（26.4 比 33.9）、（P=0.003）、血红蛋白（9.3 比 11.8 克/分升，P=0.004）和血小板计数（53 比 174 K/微升，P<.001）明显低于静脉血。计算出 726 毫升的血胸量相当于 1 单位的红细胞。
与静脉血相比，血胸血液中的凝血因子明显减少，血红蛋白含量较低。
