title: Autotransfusion of hemothorax blood in trauma patients: is it the same as fresh whole blood?
abstract: BACKGROUND
  Autotransfusable shed blood has been poorly characterized in trauma and may have similarities to whole blood with additional benefits.
  
  
  METHODS
  This was a prospective descriptive study of adult patients from whom ≥50 mL of blood was drained within the first 4 hours after chest tube placement. Pleural and venous blood samples were analyzed for coagulation, hematology, and electrolytes.
  
  
  RESULTS
  Twenty-two subjects were enrolled in 9 months. The following measured coagulation factors of hemothorax were significantly depleted compared with venous blood: international normalized ratio (>9 in contrast to 1.1, P < .001), activated partial thromboplastin time (>180 in contrast to 28.5 seconds, P < .001), and fibrinogen (<50 in contrast to 288 mg/dL, P < .001). The mean hematocrit (26.4 in contrast to 33.9), (P = .003), hemoglobin (9.3 in contrast to 11.8 g/dL, P = .004), and platelet count (53 in contrast to 174 K/μL, P < .001) of hemothorax were significantly lower than venous blood. A hemothorax volume of 726 mL was calculated to be equivalent to 1 U of red blood cells.
  
  
  CONCLUSIONS
  Hemothorax blood contains significantly decreased coagulation factors and has lower hemoglobin when compared with venous blood.
authors.affiliation: Division of Trauma and Emergency Surgery, Department of Surgery, University of Texas Health Science Center, San Antonio, TX 78229, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Salhanick
authors.forename: Michael
authors.initials: M
authors.lastname: Corneille
authors.forename: Russell
authors.initials: R
authors.lastname: Higgins
authors.forename: John
authors.initials: J
authors.lastname: Olson
authors.forename: Joel
authors.initials: J
authors.lastname: Michalek
authors.forename: Chantal
authors.initials: C
authors.lastname: Harrison
authors.forename: Ronald
authors.initials: R
authors.lastname: Stewart
authors.forename: Daniel
authors.initials: D
authors.lastname: Dent
mesh_terms: D001804:Blood Transfusion, Autologous / Q000379:methods*; D004322:Drainage / Q000379:methods*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006491:Hemothorax / Q000097:blood* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011446:Prospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D005340:Fibrinogen