Autotransfusion from Experimental Hemothorax

Napoli, Victor M.; Symbas, Peter J; Vroon, David H.; Symbas, Panagiotis N.

doi:10.1097/00005373-198703000-00012

Cited by 24 publications

(11 citation statements)

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“…This observation is confirmed by an experiment in dogs in which the inoculation of blood or of a solution containing fibrinogen and thrombin into the pleural cavity caused the activation of the coagulation system followed by a rapid fibrinogenolysis/fibrinolysis, allowing to the inoculated blood to remain in the large part fluid. 16 These early findings have been later confirmed by another experimental study in dogs 17 and by clinical studies in humans with hemothorax. 18,19 Similar results have also been found after the inoculation of blood in the peritoneal cavity of dogs, which remains in the large part fluid unless these dogs were pretreated by continuous infusion with epsilon-aminocaproic acid (an antifibrinolytic drug) before and during the experiment.…”

Section: Discussionmentioning

confidence: 75%

Hemostatic Findings in Ascitic Fluid: A Cross‐Sectional Study in 70 Dogs

Zoia

Drigo

Piek

et al. 2016

Veterinary Internal Medicne

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BackgroundAscitic fluids of horses and humans have fibrinolytic activity, independent of the underlying mechanism of fluid formation.ObjectiveTo determine whether coagulation and fibrinogenolytic/fibrinolytic activity (ie, low fibrinogen and increased fibrin–fibrinogen degradation products [FDPs], D‐dimer, or both) occur in all types of ascitic fluid in dogs.AnimalsA total of 70 client‐owned dogs with ascites.MethodsIn this cross‐sectional study, dogs were categorized based on the pathophysiology of fluid formation into 4 groups: transudates due to decreased osmotic pressure, transudates due to increased hydrostatic pressure, exudates, and hemorrhagic ascites. Fibrinogen, FDPs, and D‐dimer concentrations were measured and then compared in both ascitic fluid and plasma.ResultsTen dogs had transudates due to decreased colloid osmotic pressure, 18 had transudates due to increased hydrostatic pressure, 13 had exudates, and 29 had hemorrhagic ascites. Ascitic fibrinogen concentrations (n = 70) were significantly lower (median = 59 mg/dL; range: 59–122 mg/dL) than those in the plasma (median = 168 mg/dL, range: 59–879 mg/dL; P < .0001). Ascitic FDPs concentrations (n = 70) were significantly higher (<5 μg/mL: 3/70 dogs, ≥5 to <20 μg/mL: 11/70 dogs, ≥20 μg/mL: 56/70 dogs) than those in the plasma (<5 μg/mL: 17/70 dogs, ≥5 to <20 μg/mL: 28/70 dogs, ≥20 μg/mL: 25/70 dogs; P < .0001). Ascitic D‐dimer concentrations (n = 70) were significantly higher (median = 3.98 μg/mL, range: 0.02–9.19) than those in the plasma (median = 0.11 μg/mL, range: 0.01–4.08; P < .0001). Analysis of the data for each of the 4 different types of ascites showed similar results to those of all the data analyzed together.Conclusions and Clinical ImportanceAscitic fluid of dogs has evidence of coagulation activation and fibrinogenolytic/fibrinolytic activity and that this phenomenon occurs independent of the underlying mechanism that leads to the formation of ascites.

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Section: Discussionmentioning

confidence: 75%

Hemostatic Findings in Ascitic Fluid: A Cross‐Sectional Study in 70 Dogs

Zoia

Drigo

Piek

et al. 2016

Veterinary Internal Medicne

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“…During the procedure, the dissection of the diseased lung and pleural surface in a fully anticoagulated patient resulted in massive haemorrhage. The use of a cell-saver device and reinfusion of blood is associated with dilution of endogenous clotting factors, specifically fibrinogen, factors V, VIII, X 7 , reduction in platelet numbers and function 8 and activation of cellular and humoral inflammatory mediators 9 .…”

Section: Discussionmentioning

confidence: 99%

Recombinant Activated Factor VII for Exsanguinating Haemorrhage Post Bilateral Lung Transplantation for Extra-corporeal Lung Support-dependent Respiratory Failure

Lucey

Myburgh

2003

Anaesth Intensive Care

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Following three weeks of extracorporeal lung support for acute respiratory distress syndrome, a 15-year-old male underwent bilateral lung transplantation. This procedure was complicated by massive postoperative haemorrhage. The administration of recombinant activated Factor VII was associated with improved haemostasis. However, development of cardiac tamponade soon after injection required emergency exploration and evacuation of a large mediastinal clot.

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“…Animal studies of autologous transfusion after haemorrhage have revealed varying degrees of coagulopathy (Rakower et al, 1974;Silva et al, 1984;Napoli et al, 1987). In a canine model of thoracic trauma, Napoli et al evaluated the impact of autotransfusion of unwashed blood from a haemothorax (Napoli et al, 1987).…”

Section: Exacerbation Of Coagulopathymentioning

confidence: 99%

Autologous blood transfusion in trauma

Bulger

Maier

2001

Trauma

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Transfusion of autologous blood, recovered from the surgical field, has been widely accepted for use in elective cases with significant blood loss. The use of these techniques in the setting of exsanguinating traumatic haemorrhage has been limited, however, by a number of confounding issues. These include: (a) the potential for increased infectious complications resulting from the reinfusion of blood from a contaminated field; (b) the risk of exacerbating a consumptive coagulopathy; (c) a potential increased risk of multiple organ failure syndrome due to the infusion of cytokines and activated inflammatory mediators; (d) the practicality and logistics of this approach in the moribund patient; and (e) the costeffectiveness of this technology. The purpose of this review is to evaluate the current literature addressing these issues and better define the role for autologous transfusion in the trauma population.

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Autotransfusion from Experimental Hemothorax

Cited by 24 publications

References 0 publications

Hemostatic Findings in Ascitic Fluid: A Cross‐Sectional Study in 70 Dogs

Hemostatic Findings in Ascitic Fluid: A Cross‐Sectional Study in 70 Dogs

Recombinant Activated Factor VII for Exsanguinating Haemorrhage Post Bilateral Lung Transplantation for Extra-corporeal Lung Support-dependent Respiratory Failure

Autologous blood transfusion in trauma

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