Prehospital autotransfusion in life-threatening hemothorax
TL;DR: The preliminary results of this study suggest that autotransfusion might be developed in the prehospital setting since it appears simple and safe, and represents the only hope of survival for patients with life-threatening hemothorax.
About: This article is published in Chest.The article was published on 1988-03-01. It has received 38 citations till now. The article focuses on the topics: Autotransfusion & Hematocrit.
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TL;DR: La prevention de the transfusion sanguine en urgence devient une preoccupation de plus en plus importante (limitation de l’hemodilution, traitement des facteurs d’hypotension non lies a l“hypovolemie, embolisation precoce, chirurgie de sauvetage) and l”autotransfusion est la seule alternative actuellement envisageable.
3 citations
Cites background from "Prehospital autotransfusion in life..."
...L’autotransfusion des hémothorax traumatiques est la technique la plus ancienne et la plus répandue [22]....
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...Journal Officiel 2002;5 mai: 8703-9 [22] Barriot P, Riou B, Viars P....
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...cette technique [22]....
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01 Jan 1993
TL;DR: Echocardiography has proven to be a reliable and valuable means for the assessment of thoracic trauma and may be essential for adequate resuscitation and anesthesia of the multiple trauma patient.
Abstract: Trauma is the leading cause of death in patients under 50 years. Thoracic trauma is frequent and accounts for one third of admissions in trauma centers. During road accident, thoracic trauma occurs in 50% of patients who die at the scene, and is considered to be the main cause of death in 25% of these patients [1]. Among patients with blunt thoracic trauma, few of them require emergency surgery. However, an accurate assessment of thoracic lesions is crucial for the survival of the multiple trauma patient. In addition to rare indications for immediate thoracotomy because of severe intrathoracic blood loss, delayed surgery may be mandatory in some patients with great vessel injury. Moreover, assessment of non-surgical lesions such as pulmonary and cardiac confusion or pneumothorax may be essential for adequate resuscitation and anesthesia of the multiple trauma patient. Piain chest X-ray, angiography, and computerized tomography (CT) have been extensively used to assess severe thoracic trauma. Recently, echocardiography has proven to be a reliable and valuable means for the assessment of thoracic trauma.
3 citations
TL;DR: This article is the first described case where an autotransfusion system has been implemented in a prehospital setting, at a Role 1 medical facility, for massive hemothorax in Afghanistan.
Abstract: Massive hemothorax is a life-threatening condition that can present as hemorrhagic shock, cardiogenic shock, or elements of both. It is described by the American College of Surgeons, in the 9th Edition of Advanced Trauma Life Support, as a rapid accumulation of more than 1,500 mL of blood or one-third or more of the patient's blood volume. The use of autotransfusion systems has been implemented for the treatment of hemothorax in hospital settings. The implementation of autotransfusion has been documented in situations where an extended period can elapse before definitive treatment can occur. This article is the first described case where an autotransfusion system has been implemented in a prehospital setting, at a Role 1 medical facility, for massive hemothorax in Afghanistan.
3 citations
01 Jan 2004
TL;DR: A simple but salvaging procedure for pre-operative autotransfusion, which might be well indicated in the medico-surgical management of severe traumatic hemothorax in the African milieu.
Abstract: SUMMARY: The author describes a simple but salvaging procedure for pre-operative autotransfusion, which might be well indicated in the medico-surgical management of severe traumatic hemothorax in the African milieu.
2 citations
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102 citations
TL;DR: The preliminary results of the antishock trouser in this setting are encouraging and the treatment of bradycardia per se may be deleterious and atropine must be avoided in conscious patients with hemorrhagic shock and paradoxical bradyCardia.
Abstract: Two hundred and seventy-three acute hemorrhagic shocks were treated in 1984 in a pre-hospital emergency care unit. Twenty patients (7%) had a paradoxical bradycardia: they were conscious, 9 of them had an undetectable systolic arterial pressure with the sphygmomanometric method but the femoral pulse was still present. All of them recovered from bradycardia with fluid loading alone. The comparison between patients with paradoxical bradycardia and those with tachycardia showed that the former had more severe and rapid hemorrhages. During 1985, 7 new cases of acute hemorrhagic shock with paradoxical bradycardia were treated with an antishock trouser. These patients recovered from bradycardia more quickly (p less than 0.01) and with a less important fluid loading (p less than 0.01) than those previously treated without the antishock trouser. Two other patients were treated with atropine before antishock trouser inflation and experienced ventricular premature beats and one developed ventricular fibrillation. A paradoxical bradycardia can occur in hemorrhagic shock and denotes a rapid and severe hemorrhage requiring a massive and rapid fluid loading. The preliminary results of the antishock trouser in this setting are encouraging. The treatment of bradycardia per se may be deleterious and atropine must be avoided in conscious patients with hemorrhagic shock and paradoxical bradycardia.
72 citations
49 citations
TL;DR: No alteration in lipoproteins or elevation of plasma lipids was found with prolonged autotransfusion and no fat emboli were observed histologically.
Abstract: The effects of autotransfusion on cellular and other components of autologous blood were studied in forty adult dogs. An increase in free plasma hemoglobin and a decrease in hematocrit, red blood cells, and white blood cells were seen immediately after autotransfusion with canine blood exposed to the peritoneal cavity (group II) and blood collected in a siliconized beaker (group I). After autotransfusion, a significant decrease in platelets and a significantly higher free plasma hemoglobin level were noted in dogs in group II. In the five day period after autotransfusion the white blood cell and fibrinogen levels remained elevated whereas free plasma hemoglobin, hematocrit, red blood cell, and platelet levels returned to near normal. Prothrombin time, thrombin time, and partial thromboplastin time were within normal limits throughout the experimental period. Red blood cell survival after autotransfusion was found to be normal relative to controls. Screen filtration pressure was markedly elevated in blood suctioned from the abdominal cavity. Filtration with the autotransfusion reservoir filter resulted in a decrease in screen filtration pressure to a measurable but elevated level whereas screen filtration pressure returned to normal after Dacron wool filtration. No alteration in lipoproteins or elevation of plasma lipids was found with prolonged autotransfusion and no fat emboli were observed histologically. All dogs survived and showed no evidence of bleeding, thrombosis, or insult to pulmonary or other organ system function.
37 citations
Journal Article•
36 citations