An in Vivo Evaluation of Microaggregate Blood Filtration during Total Hip Replacement

TRALI – Definition, mechanisms, incidence and clinical relevance

“…In massive transfusion, the mechanism of lung injury was initially thought to be microaggregates in stored blood causing micro-pulmonary emboli and lung damage, but this theory has been discredited, since transfusion of stored blood through microaggregate filters has not prevented lung injury in animals (15) nor in humans (16,17). Pathologically, the disease involves sequestration of activated neutrophils within the pulmonary capillaries, leading to acute lung injury (18).…”

Is There a Rationale for Using a Proteinase Inhibitor as a Standard Additive to Stored Blood?

“…The apparently logical conclusion was that the pulmonary pathology resulted from the transfusion. However, subsequent animal studies remained equivocal, one obvious cause being differences between experimen tal designs and animal species [19], A num ber of 'microfilters' became available and underwent clinical trials [1,31,33]. These trials revealed that in routine transfusions up to about 50% of the recipient's blood volume and without preexisting pulmonary dys function such filters offer no clinical advan tages over the standard 170-pm filters, and that they are thus superfluous under such circumstances.…”

Preparation of Granulocyte-Poor Red Blood Cells by Microaggregate Filtration

“…It is agreed that these fil ters remove aggregated debris more efficient ly than the standard administration set fil ters, but their necessity and clinical benefit have not been proven conclusively [10]. Therefore, their role in transfusion therapy is currently undefined.…”