Timberlake G A, McSwain N E
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112.
J Trauma. 1988 Jun;28(6):855-7. doi: 10.1097/00005373-198806000-00026.
The role of autotransfusion of shed blood is well established in thoracic, abdominal, vascular, and orthopedic elective surgery. When hollow viscera or infected organs are uninvolved, autotransfusion is also well accepted in trauma surgery. Less clear is whether shed blood from an injury violating hollow organs in the abdomen can be used safely in the trauma patient. We retrospectively identified 11 patients with penetrating thoracoabdominal trauma who had received enteric contaminated shed blood, processed by the Haemonetics Cell Saver, and reviewed their records for infectious morbidity or mortality. All patients received parenteral broad-spectrum antibiotics. Three patients developed infectious wound complications, one probably nosocomial from the intensive care unit. No patient developed intra-abdominal sepsis and no deaths were reported. Based on the results of this preliminary result, it may be appropriate to use autotransfusion of shed blood in trauma patients with gastrointestinal injuries, if banked blood is not readily available and the patients receive perioperative broad-spectrum antibiotics.
自体输血在胸科、腹部、血管和骨科择期手术中的作用已得到充分确立。当空腔脏器或感染器官未受累时，自体输血在创伤手术中也被广泛接受。腹部创伤累及空腔脏器时流出的血液能否安全用于创伤患者尚不清楚。我们回顾性地确定了11例穿透性胸腹联合伤患者，他们接受了经Haemonetics血液回收机处理的受肠道污染的流出血液，并查阅了他们的感染发病率或死亡率记录。所有患者均接受了肠外广谱抗生素治疗。3例患者出现感染性伤口并发症，其中1例可能是重症监护病房的医院感染。没有患者发生腹腔内感染，也没有死亡报告。基于这一初步结果，如果库存血难以获得且患者接受围手术期广谱抗生素治疗，那么在有胃肠道损伤的创伤患者中使用自体输血可能是合适的。
