The anemia of trauma

1. The anemia of civilian trauma (mainly limb injuries) has been studied in57 patients.

2. In 22 patients the red cell volume, after primary blood loss has probablyceased, has been compared with the follow-up "normal" red cell volume. Thered cell volume credit or deficit is taken as an index of the balance betweenprimary blood loss and blood transfused, and was found to be the major factorcontributing to the later polycythemia or anemia. The evidence suggests that ananemia of trauma due to unreplaced primary blood loss is still a common findingin civilian injuries today.

3. A further red cell volume estimate in 20 patients on the 4-14th day afterinjury showed on average a further fall of 11 per cent of the red cell volume.Evidence is presented for considering that there is a further disappearance ofred cells after primary blood loss has ceased in all patients—even in those whosered cell volume did not fall.

4. The evidence suggests that the anemia of trauma is largely preventable byadequate blood transfusion in the majority of civilian injuries.

Submitted on August 15, 1955 Accepted on October 15, 1955