• Marc Salhanick, Michael Corneille, Russell Higgins, John Olson, Joel Michalek, Chantal Harrison, Ronald Stewart, and Daniel Dent.
• Division of Trauma and Emergency Surgery, Department of Surgery, University of Texas Health Science Center, San Antonio, TX 78229, USA.
• Am. J. Surg. 2011 Dec 1; 202 (6): 817-21; discussion 821-2.

BackgroundAutotransfusable shed blood has been poorly characterized in trauma and may have similarities to whole blood with additional benefits.MethodsThis 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.ResultsTwenty-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.ConclusionsHemothorax blood contains significantly decreased coagulation factors and has lower hemoglobin when compared with venous blood.Copyright © 2011 Elsevier Inc. All rights reserved.

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