AUTOTRANSFUSION WITH BLOOD FROM HEMOTHORA X USING THE CONSTAVAC(TM) DEVICE

The technique of autotransfusion with blood drained from a haemothorax has been described nearly 80 years ago. The shed blood is easy to col lect and is incoagulable. This technique as two indications: lifesavin g autotransfusion in the prehospital phase and blood saving and/or tra nsfusional safety at hospital arrival. This prospective study assessed its value as well as the advantages and disadvantages of the ConstaVa c(TM) system in 30 patients suffering from haemothorax. This apparatus consists of a 800 mt collecting reservoir on a support equipped with an electric aspirator and a battery. The collected blood is transferre d into a reinfusion bag while remaining in a closed circuit. The retra nsfused volume was 685 +/- 430 mt, representing 80 % of the collected volume. The retransfusion took place in less than four hours. The pati ents with an isolated haemothorax did not receive any homologous blood . Only one technical problem occurred, related to the excessive volume of the haemothorax. The shed blood has a decreased content of platele ts, fibrinogen, and is incoagulable. Moreover, it is haemolyzed. Its h ematocrit is lower than the patient's one. On the other hand, the conc entration of 2,3 DPG remains normal. These modifications have no detri mental consequences on the patients as long as the autotransfused volu me does not exceed two litres. Infectious problems are rare. Handling requires strict asepsis. The ConstaVac(TM) system is marketed for post operative autotransfusion. It is compact, self-contained and very easy to use. It is the only system able of ensuring blood drainage and ret ransfusion simultaneously, without requiring any opening of the circui t. Its only limitation is related to the volume of the haemothorax. Au totransfusion with blood drained from haemothorax is simple, safe and effective. It should be developed in emergency departments. The Consta Vac(TM) system seems to be perfectly adapted to this technique.