Bonfils-Roberts E A, Stutman L, Nealon T F
Ann Surg. 1977 Mar;185(3):321-5. doi: 10.1097/00000658-197703000-00013.
Severe hemorrhage associated with major trauma and vascular procedures is seen frequently in our operating rooms. Immediate autotransfusion has enabled us to safely and adquately correct blood losses without placing overwhelming demands on our blood bank. Since October 1973, a device capable of retrieving, filtering and reinfusing blood lost during operation has been used on 51 patients (major trauma, 20; ectopic pregnancy, 2; portacaval shunt, 9; peripheral vascular surgery, 20). From 700 to 20,000 cc's of blood were reinfused. Platelets, hematocrit, fibrinogen, free plasma hemoglobin, bilirubin, and creatinine showed no significant changes as compared to preoperative values in 39 survivors. There were 12 deaths. Eight died postoperatively as a result of their injuries, 3 of uncontrollable bleeding and one of renal failure. This study shows that autotransfusion, when used with proper operating technique, is a most satisfactory technique for restoring blood volume in severe trauma cases and elective vascular operations. This method provides a rapid, simple way of reinfusing fresh blood, free of hepatitis contamination with minimal derangement in cellular and plasma coagulation parameters.
在我们的手术室中，严重创伤和血管手术相关的严重出血情况屡见不鲜。即时自体输血使我们能够安全、充分地纠正失血，而不会给血库带来巨大压力。自1973年10月以来，一种能够回收、过滤并回输手术中流失血液的装置已应用于51例患者（严重创伤20例；宫外孕2例；门腔分流术9例；外周血管手术20例）。回输的血量从700到20000毫升不等。39名幸存者的血小板、血细胞比容、纤维蛋白原、游离血浆血红蛋白、胆红素和肌酐与术前值相比无显著变化。共有12例死亡。8例术后因伤死亡，3例死于无法控制的出血，1例死于肾衰竭。本研究表明，自体输血结合适当的手术技术，是严重创伤病例和择期血管手术中恢复血容量的最令人满意的技术。该方法提供了一种快速、简单的回输新鲜血液的方式，无肝炎污染，细胞和血浆凝血参数的紊乱最小。
