In this VETgirl online veterinary continuing education blog, we demonstrate how to perform an autotransfusion in a dog with a traumatic hemoabdomen. In this video, a 5-year-old pit bull terrier was hit by a car and presented with a severe hemoabdomen. Initial volume resuscitation included fluid resuscitation with crystalloids, colloids, packed red blood cells (pRBCs) and finally auto-transfusion.

The benefit of autotransfusion, is that it is a readily available transfusion product available from the patient. As it is from the patient, it will not result in a transfusion reaction. However, autotransfusions should only be performed when there is no evidence of contamination from urine (e.g., uroabdomen), bile (e.g., bile peritonitis), bacteria (e.g., septic peritonitis), neoplastic cells (e.g., hemoangiosarcoma), etc.

As the blood has already undergone fibrinolysis, there is no need to add anticoagulants (such as CPDA, etc.) to autotransfusions during collection. Ideally, blood should be sterilely collected in 60 ml sterile syringes. A blood filter should be used when administering the autotransfusion back to the patient. Alternatively, one can collect the blood via a three-way stopcock system and collect it directly into a sterile bag (e.g., a used IV fluid bag).

Transfusion

As this dog had evidence of severe hemorrhagic shock that was non-responsive to crystalloid/colloid resuscitation, transfusion with red blood cells needs to be performed immediately. Blood can be bolused in as quickly as needed in severe cases.

Remember, our ultimate goal with administration of any type of blood product is to increase oxygen delivery (DaO2) with red blood cells! When in doubt, don’t be hesitant to perform an autotransfusion, but make sure you’re using the transfusion product correctly and when it is not contraindicated!

  1. I have been using autotransfusion since 1980. Great job on your case. The most blood or mixture of blood and saline I have autotransfused in the last few years has been 4 L given to a Great Dane with a ruptured spleen caused by a gastric dilatation volvulus. The dog continue to not have proper care for a while so the abdominal blood kept continuing to accumulate in her abdominal cavity. She was 12 years old when she had the GDV. We removed and gave back 3 L of blood at the time we found the blood in her abdomen and at the time of the splenic removal and repositioning of the stomach. We gave the last liter collected in ICU. She made a complete recovery. Dr DT Crowe

  2. I do not agree with all you said. Please call me so we can discuss if you want to. We published 12 cases of AT in the IVECCS Proceedings and some of these cases had bacterial contamination and some had hemangiosarcoma. 8 of the 12 survived long term. When you gave no choice you sometimes have to try. Even if it’s your only option. I often use a suction unit to collect the blood and then pour the blood out of the suction reservoir into to top of a plastic IV bag that has a corner removed. It’s then given – best with a blood filter but 6 of the cases I reported on at IVECCS did not have luxury of getting it filtered with a blood filter and only filtered with the lap pad used around the Yankauer suction tip in the abdomen. Oh forgot to mention only 2 had a sterile reservoir. I got a lot of my ideas from papers articles and books published from the history of autotransfusion during the Civil, and First and Second World War. One case reported I will aways remember. It was a German Soldier that had be shot in the stomach and liver who survived. Some of the several pints had gross cabbage leaves (probably from his stomach contents) collected on the surgical sponges used to filter the blood before it was autotransfused. Again he survived and was sent to a Prision camp. Please let me know if I can help you teach at VetGirl

Leave a Reply

Your email address will not be published.