Duncan S E, Klebanoff G, Rogers W
Ann Surg. 1974 Sep;180(3):296-304. doi: 10.1097/00000658-197409000-00007.
Utilizing a disposable unit, intraoperative autotranfusion was employed during surgery in 53 patients admitted to the Bexar County Teaching Hospital at the University of Texas Health Science Center at San Antonio. During the two-year period of study, 26 patients underwent surgery for major traumatic injuries, 8 for ruptured ectopic pregnancy and 19 for miscellaneous emergency or elective conditions. The indication for intraoperative autotransfusion was an anticipated blood loss of 1,000 ml or more. Contraindications for its use were colon injury or localized infection. Over 325 units of blood were salvaged and returned directly to these patients during surgery. One death related to the use of the autotransfusor unit was due to massive air embolism. Twenty other deaths were associated with severe injuries and irreversible shock requiring greater than 3,600 ml of both autologous and homologous blood. Eight of these patients demonstrated severe pancoagulopathies. In the remaining patients, clotting factors and plasma or urine hemoglobin levels were transiently abnormal. However, there were no clinically apparent bleeding defects or renal problems detected. Postoperative blood cultures were consistently negative. It is concluded that intraoperative autotransfusion, when properly employed, is a safe, practical and technically feasible procedure.
在圣安东尼奥市德克萨斯大学健康科学中心的贝萨尔县教学医院，对53例住院手术患者使用一次性装置进行术中自体输血。在为期两年的研究期间，26例患者接受了严重创伤手术，8例因异位妊娠破裂接受手术，19例因各种急诊或择期病症接受手术。术中自体输血的指征是预计失血量达1000毫升或更多。其使用的禁忌症为结肠损伤或局部感染。手术期间，超过325单位的血液被回收并直接回输给这些患者。与使用自体输血装置相关的1例死亡是由于大量空气栓塞。另外20例死亡与重伤及不可逆休克有关，需要输注超过3600毫升的自体血和同源血。其中8例患者出现严重的全凝血病。其余患者的凝血因子、血浆或尿血红蛋白水平短暂异常。然而，未检测到明显的临床出血缺陷或肾脏问题。术后血培养结果始终为阴性。结论是，术中自体输血若使用得当，是一种安全、实用且技术上可行的操作。
