scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Prehospital autotransfusion in life-threatening hemothorax

01 Mar 1988-Chest (Elsevier)-Vol. 93, Iss: 3, pp 522-526
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.
Citations
More filters
Journal ArticleDOI
TL;DR: This chapter compares the US EMS system, where the role of the physician is limited, and the French SAMU system, which was created and is run by anaesthetists.
Abstract: Summary The involvement of physicians, and especially anaesthetists, in prehospital care is very different from one EMS system to another In this chapter we mainly compare the US EMS system, where the role of the physician is limited, and the French SAMU system, which was created and is run by anaesthetists Despite major differences in the bases of these two organizations, there are some common points as far as involvement of the physician is concerned: medical control, leadership and education and research need the presence of a trained physician with strong field experience
Journal ArticleDOI
TL;DR: In Francia, lesiones torácica provocada by a mecanismo de desaceleración repentina is más probable that cause lesions of tipo cerrado as mentioned in this paper .
Journal ArticleDOI
TL;DR: Comparing both methods, it is concluded that blood autotransfusion has numerous advantages over heterologous transfusion, even in large hospitals.
Abstract: The objective is to reinforce the importance of blood reinfusion as a cheap, safe and simple method, which can be used in small hospitals, especially those in which there is no blood bank. Moreover, even with the use of devices that perform the collection and filtration of blood, more recent studies show that the cost-benefit ratio is much better when autologous transfusion is compared with blood transfusions, even when there is injury to hollow viscera and blood contamination. It is known that the allogeneic blood transfusion carries a number of risks to patients, among them are the coagulation disorders mediated by excess enzymes in the conserved blood, and deficiency in clotting factors, mainly the Factor V, the proacelerin. Another factor would be the risk of contamination with still unknown pathogens or that are not investigated during screening for selection of donors, such as the West Nile Fever and Creutzfeldt-Jacob, better known as "Mad Cow" disease. Comparing both methods, we conclude that blood autotransfusion has numerous advantages over heterologous transfusion, even in large hospitals. We are not against blood transfusions, just do not agree that the patient's own blood is discarded without making sure there will be enough blood in stock to get him out of the hemorrhagic shock.
References
More filters
Journal ArticleDOI
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

Journal ArticleDOI
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