A small amount can make a difference: a prospective human study of the paradoxical coagulation characteristics of hemothorax

Smith, William Zachary; Harrison, Hannah; Salhanick, Marc; Higgins, Russell A.; Ortiz, Alfonso; Olson, John D.; Schwacha, Martin G.; Harrison, Christopher; Aydelotte, Jayson; Stewart, Ronald M.; Dent, Daniel L.

doi:10.1016/j.amjsurg.2013.08.004

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…Immediate pericardial thrombus is an extremely rare possibility because small amounts of blood in the pericardial space do not result in immediate clot formation 8 . In fact, intracavitary blood has long been known to be incoagulable, 9 and even though evidence for pericardial effusions does not exist, extrapolation of hemothorax characteristics suggests that hemopericardium is defibrinated and thrombocytopenic, and contains elevated levels of d -dimers 10 . Accordingly, early development of pericardial thrombus is an unlikely finding.…”

Section: Discussionmentioning

confidence: 99%

Thrombotic cardiac tamponade after transseptal puncture

Katritsis

Zografos

Giazitzoglou

et al. 2015

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 99%

Thrombotic cardiac tamponade after transseptal puncture

Katritsis

Zografos

Giazitzoglou

et al. 2015

HeartRhythm Case Reports

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“…Several experimental studies [100][101][102][103] have assessed the paradoxical characteristics of the composition of blood retrieved from a haemothorax. One first question was whether the composition of blood recovered would be equal or similar to fresh whole blood, but it was found to be haemodiluted.…”

Section: Haemothoraxmentioning

confidence: 99%

“…According to these experiments, autotransfusion of a haemothorax would likely result in a hypercoagulable state in vivo. However, it may be useful in resource-limited settings [100][101][102][103].…”

Section: Haemothoraxmentioning

confidence: 99%

Cell Salvage in Oncological Surgery, Peripartum Haemorrhage and Trauma

2022

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Oncological surgery, obstetric haemorrhage and severe trauma are the most challenging conditions for establishing clinical recommendations for the use of cell salvage. When the likelihood of allogeneic transfusion is high, the intraoperative use of this blood-saving technique would be justified, but specific patient selection criteria are needed. The main concerns in the case of oncological surgery are the reinfusion of tumour cells, thereby increasing the risk of metastasis. This threat could be minimized, which may help to rationalize its indication. In severe peripartum haemorrhage, cell salvage has not proven cost-effective, damage control techniques have been developed, and, given the risk of fetomaternal alloimmunization and amniotic fluid embolism, it is increasingly out of use. In trauma, bleeding may originate from multiple sites, coagulopathy may develop, and it should be evaluated whether re-transfusion of autologous blood collected from uncontaminated organ cavities would be feasible. General safety measures include washing recovered blood and its passage through leukocyte depletion filters. To date, no well-defined indications for cell salvage have been established for these pathologies, but with accurate case selection and selective implementation, it could become safe and effective. Randomized clinical trials are urgently needed.

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“…In the trauma literature, there has also been evaluation of the quality of the blood. Smith et al [29] looked at the coagulation profile of blood from the pleural cavity. They found an increase in INR, aPTT, and d dimer, and a marked decrease in fibrinogen and platelet concentration.…”

Section: Key Pointsmentioning

confidence: 99%

Cell salvage in trauma

Waters¹

2021

Current Opinion in Anaesthesiology

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Purpose of reviewThe collection of shed blood and its reinfusion has been termed 'cell salvage' or 'autotransfusion'. This review will summarize the historical foundation of cell salvage and summarize recent literature associated with cell salvage use in trauma. Recent findingsThere have been no publications on cell salvage in trauma during the last 2 years. This is based on a PubMed search using the key words, 'cell salvage', 'autologous blood transfusion' and 'operative blood salvage'. Although the wars in Iraq and Afghanistan were ongoing, publications focused upon autotranfusion of unwashed blood from the hemothorax and on the resuscitation of the injured in remote settings.

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A small amount can make a difference: a prospective human study of the paradoxical coagulation characteristics of hemothorax

Cited by 11 publications

References 13 publications

Thrombotic cardiac tamponade after transseptal puncture

Thrombotic cardiac tamponade after transseptal puncture

Cell Salvage in Oncological Surgery, Peripartum Haemorrhage and Trauma

Cell salvage in trauma

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