Utilization of blood recycling in nonelective surgery
J. F. Huth, R. V. Maier, E. G. Pavlin and C. J. Carrico
Intraoperative infusion of autologous shed blood is efficacious in elective
vascular, cardiac, and orthopedic surgery. Blood recycling has also been
advocated for emergency and trauma surgery. We examined 33 candidates for
autotransfusion during emergency surgery. Autologous blood accounted for
only 11% of the total blood replaced. Only 25 of the patients survived long
enough to permit reinfusion. Because of rapid hemostasis, nine of the
remaining patients (36%) received less than the 2 units necessary to be
cost-effective. No evidence was found for septicemia or coagulopathy caused
by autotransfusion. We concluded that, as currently applied, recycling of
shed blood during emergency surgery is of value in a limited group of
patients. The collection and storage of heparinized shed blood during the
preoperative and early intraoperative periods, with later processing and
reinfusion in selected patients, may expand its applicability.
