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June 22, 1984

A Clinical Review of Autotransfusion and Its Role in Trauma

Author Affiliations

From the Emergency Medical Services, Boston City Hospital, and the Departments of Surgery and Emergency Medical Services, Boston University School of Medicine (Dr Jacobs); and the Trauma Program, Hartford Hospital, University of Connecticut, Hartford (Dr Hsieh). Dr Jacobs is now with the Trauma Program, Hartford Hospital, University of Connecticut, Hartford.

JAMA. 1984;251(24):3283-3287. doi:10.1001/jama.1984.03340480065032

AUTOTRANSFUSION is defined as the collection and reinfusion of a patient's own blood. The first description of autotransfusion dates back to 1818, when Blundell1 used it in London to counter postpartum hemorrhage, with a mortality of 50%. Autotransfusion in the setting of chest trauma was first recorded by Elmendorf2 during battle in 1917 and in civilian life in 1931. The earliest reported American application of autotransfusion was attributed to Lockwood3 intraoperatively during a splenectomy in 1917.

Early literature of the 1920s and 1930s reported autotransfusion more commonly used for intra-abdominal hemorrhage, ie, ruptured ectopic pregnancies and traumatic vascular injuries. Its application in chest or pleural cavity injuries was limited to a few sporadic cases. The reluctance for such use stemmed from the fear of contamination of the shed blood.

With the advent of blood typing and cross matching, homologous blood from banks became the standard blood replacement