The incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of cardiac surgery patients: a prospective nested case-control study

Vlaar, Alexander P.J.; Hofstra, Jorrit J.; Determann, Rogier M.; Veelo, Denise P.; Paulus, Frederique; Kulik, Wim; Korevaar, Johanna C.; Mol, Bas A.J.M. de; Koopman, Marianne M; Porcelijn, Leendert; Binnekade, Jan M.; Vroom, Margreeth B.; Schultz, Marcus J.; Juffermans, Nicole P.

doi:10.1182/blood-2010-10-313973

Cited by 188 publications

(193 citation statements)

References 48 publications

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“…All observational studies compared patients who did and did not receive RBC transfusion. Only one study stated that all RBCs administered to participants were leucodepleted 45 . Only 12 studies reported numbers of RBC units transfused: the median number per patient ranged from 3 to 8.…”

Section: Role Of Funding Sourcementioning

confidence: 99%

Indications for red blood cell transfusion in cardiac surgery: a systematic review and meta-analysis

Patel

Avlonitis

Jones

et al. 2015

The Lancet Haematology

111

106

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(2015). Indications for red blood cell transfusion in cardiac surgery: A systematic review and meta-analysis. Lancet Haematology, 2(12), e543-e553. DOI: 10.1016/S2352-3026 (15) University of Bristol -Explore Bristol Research General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available:

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Section: Role Of Funding Sourcementioning

confidence: 99%

Indications for red blood cell transfusion in cardiac surgery: a systematic review and meta-analysis

Patel

Avlonitis

Jones

et al. 2015

The Lancet Haematology

111

106

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“…Such large range in incidence could be attributed to the relatively unspecific diagnostics tools available for TRALI, past cases of under-diagnosis or misdiagnosis, and the elevated incidence of TRALI within vulnerable populations [14][15][16]. A recent study analyzing the incidence of TRALI in critically ill patients admitted to intensive care unit (ICU) observed that over 5% of all patients who received blood transfusion developed TRALI, which is 50-100 times greater occurrence than in the general hospital population [12,17].…”

Section: Demographicsmentioning

confidence: 99%

Storage of Red Blood Cells and Transfusion-Related Acute Lung Injury

Babaev

Pozzi

Hare

et al. 2014

JACCOA

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Transfusion-related acute lung injury (TRALI) is a major complication posttransfusion. A consensus definition of TRALI has been recently established to improve diagnosis but the pathogenesis of TRALI is yet to be understood. Although the antibody-mediated two-hit model of TRALI is the classical narrative, increasing evidence of the probable implications of prolonged storage of blood provides novel mechanisms towards storage lesion-the potentially injurious cellular and biochemical changes that occur in stored red blood cells. Red blood cell-derived lipids and micro vesicles may have been playing an important role in the development of TRALI. This article will provide a brief overview of the current understanding of TRALI and then discuss the implications and the potential mechanisms by which stored red blood cells may lead to TRALI. TRALI is characterized by clinical features that include, but not limited to, dyspnea, tachypnea, respiratory insufficiency, noncardiogenic bilateral pulmonary edema, decreased pulmonary compliance and acute hypoxemia (PaO 2 /FiO 2 <300 mmHg, (Table 1) [13,14]. KeywordsThe incidence of TRALI ranges from 1/5,000-1/1,323 transfusions within the general population and it is the leading cause of transfusion-related death in the United States [15]. Such large range in incidence could be attributed to the relatively unspecific diagnostics tools available for TRALI, past cases of under-diagnosis or misdiagnosis, and the elevated incidence of TRALI within vulnerable populations [14][15][16]. A recent study analyzing the incidence of TRALI in critically ill patients admitted to intensive care unit (ICU) observed that over 5% of all patients who received blood transfusion developed TRALI, which is 50-100 times greater occurrence than in the general hospital population [12,17]. Risk factors related to recipients and donorsThe risk factors of TRALI are highly diverse, among patients DefinitionDiagnostic Parameters TRALIBi-lateral infiltrates with non-cardiogenic pulmonary edema. ARDS appearance within 6hours after transfusion. Hypoxemia: PaO 2 /F i O 2 < 300 mmHg. Potential TRALI Similar to TRALI diagnosis with an additional risk-factor for lung injury/ARDS. Delayed TRALI Diagnostic parameters characteristic of TRALI within 24-72 hours after transfusion.

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“…Silliman's observations are confi rmed by Covin et al [26] who described an onset of TRALI in a patient after an autologous transfusion where no antibodies were detected in blood but leukocyte activation was induced by accumulation of active lipids. However, recent clinical observations and ex vivo studies question the involvement of biologically active lipids and sCD40L in TRALI development [27][28][29].…”

Section: Etiology and Pathophysiologymentioning

confidence: 99%

Transfusion-related acute lung injury: A dangerous and underdiagnosed noncardiogenic pulmonary edema

Jaworski¹,

Maślanka

Kosior³

2013

Cardiol J

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Transfusion-related acute lung injury (TRALI) is one of the leading causes of death associated with transfusion of blood and blood components. The understanding of the etiology and pathophysiology of this syndrome has much improved during the last decades, nevertheless numerous issues are still unresolved and symptomatic treatment remains the cornerstone of medical management. Consequently more attention is directed at primary as well as secondary prevention. The awareness of the problem within the medical society is still unsatisfactory which results in a high number of unrecognized cases or of inaccurate diagnoses one of which is cardiogenic pulmonary edema. The aim of this review is to make the TRALI syndrome morefamiliar to clinicians and to emphasize how signifi cant proper medical management is both for the patients presenting TRALI symptoms as well as for future recipients of blood components. (Cardiol J 2013; 20, 4: 337-344)

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The incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of cardiac surgery patients: a prospective nested case-control study

Cited by 188 publications

References 48 publications

Indications for red blood cell transfusion in cardiac surgery: a systematic review and meta-analysis

Indications for red blood cell transfusion in cardiac surgery: a systematic review and meta-analysis

Storage of Red Blood Cells and Transfusion-Related Acute Lung Injury

Transfusion-related acute lung injury: A dangerous and underdiagnosed noncardiogenic pulmonary edema

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