Noncardiogenic pulmonary edema after cardiopulmonary bypass

Hashim, Sabet W.; Kay, H. D.; Hammond, Graeme L.; Kopf, Gary S.; Geha, Alexander S.

doi:10.1016/0002-9610(84)90022-9

Cited by 62 publications

(38 citation statements)

References 3 publications

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“…Second, the lung injury in our model was characterized by increased lung vascular permeability to protein, the defining characteristic of ALI. Yost (28) and others (29,30) have reported that the undiluted pulmonary edema fluid of well-characterized patients with TRALI contains a high protein concentration consistent with increased permeability edema. Autopsy studies have also shown proteinaceous edema fluid in patients dying of TRALI (31).…”

Section: Discussionmentioning

confidence: 98%

Neutrophils and their Fc receptors are essential in a mouse model of transfusion-related acute lung injury

Looney

Su²,

Ziffle³

et al. 2006

Journal of Clinical Investigation

280

346

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Transfusion-related acute lung injury (TRALI) is the most common cause of transfusion-related mortality.To explore the pathogenesis of TRALI, we developed an in vivo mouse model based on the passive transfusion of an MHC class I (MHC I) mAb (H2K d ) to mice with the cognate antigen. Transfusion of the MHC I mAb to BALB/c mice produced acute lung injury with increased excess lung water, increased lung vascular and lung epithelial permeability to protein, and decreased alveolar fluid clearance. There was 50% mortality at a 2-hour time point after Ab administration. Pulmonary histology and immunohistochemistry revealed prominent neutrophil sequestration in the lung microvasculature that occurred concomitantly with acute peripheral blood neutropenia, all within 2 hours of administration of the mAb. Depletion of neutrophils by injection of anti-granulocyte mAb Gr-1 protected mice from lung injury following MHC I mAb challenge. FcRγ -/-mice were resistant to MHC I mAb-induced lung injury, while adoptive transfer of wild-type neutrophils into the FcRγ -/-animals restored lung injury following MHC I mAb challenge. In conclusion, in a clinically relevant in vivo mouse model of TRALI using an MHC I mAb, the mechanism of lung injury was dependent on neutrophils and their Fcγ receptors.

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Section: Discussionmentioning

confidence: 98%

Neutrophils and their Fc receptors are essential in a mouse model of transfusion-related acute lung injury

Looney

Su²,

Ziffle³

et al. 2006

Journal of Clinical Investigation

280

346

View full text Add to dashboard Cite

show abstract

“…Haemodynamic support may be required. The use of diuretics is controversial [7,18,28,82,83,86,88,89] and hasty and uncontrolled use of diuretics may be harmful [22,90,91]. The efficacy of corticosteroids in TRALI is unproven [7,18,28,82,83,86,88,89,92,93], although there are anecdotal case studies that have reported the use of high dose steroids as part of a successful treatment regimen [4, 94,95].…”

Section: Managementmentioning

confidence: 99%

Transfusion‐related acute lung injury: a literature review

Barrett

Kam

2006

Anaesthesia

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SummaryTransfusion-related acute lung injury (TRALI) is a serious and potentially fatal complication of transfusion of blood and blood components. TRALI is under-diagnosed and under-reported because of a lack of awareness. A number of models have been proposed to explain the pathogenesis of TRALI: an antibody mediated model; a two-event biologically active mediator model; and a combined model. TRALI can occur with any type of blood product and can occur with as little as one unit. Its presentation is similar to other forms of acute lung injury and management is predominantly supportive. The main strategy in combating TRALI is prevention both through manipulation of the donor pool and through clinical strategies directed at reducing transfusion of blood products including, but not limited to, evidence-based lower transfusion thresholds.

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“…O'Connor et al (12) and Hashim et al (15) also reported that saline infusion improved patients with TRALI but treatment with catecholamines and diuretics did not. Those researchers (1,14,15) stated that in patients with TRALI it is important to improve the hemodynamic status such as pulmonary capillary wedge pressure, cardiac output, and hypotension because the pulmonary edema in TRALI is related to altered vascular permeability in lungs. In the present case, the treatment for TRALI was successful, probably due to improvement of hypotension and decreased pulmonary capillary wedge pressure from the saline treatment.…”

Section: Discussionmentioning

confidence: 99%

Transfusion-related Acute Lung Injury Following Allogeneic Bone Marrow Transplantation in a Patient with Acute Lymphoblastic Leukemia

et al. 2004

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Transfusion-related acute lung injury (TRALI) is a clinical syndrome characterized by bilateral pulmonary edema in association with transfusions. We encountered a 23-year-old woman with acute lymphoblastic leukemia, in whom TRALI without anti-human leukocyte antigen class I and anti-granulocyte antibodies developed following allogeneic bone marrow transplantation. TRALI improved mainly in association with treatment of saline and ventilation support after several days, but graft-versushost disease and thrombotic microangiopathy developed, resulting in death due to multiple organ failure. This case indicates that TRALI can also occur following allogeneic bone marrow transplantation.

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Noncardiogenic pulmonary edema after cardiopulmonary bypass

Cited by 62 publications

References 3 publications

Neutrophils and their Fc receptors are essential in a mouse model of transfusion-related acute lung injury

Neutrophils and their Fc receptors are essential in a mouse model of transfusion-related acute lung injury

Transfusion‐related acute lung injury: a literature review

Transfusion-related Acute Lung Injury Following Allogeneic Bone Marrow Transplantation in a Patient with Acute Lymphoblastic Leukemia

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