Transfusion-related Acute Lung Injury: Report of Two Cases

Čermáková, Zuzana; Kořístka, Martin; Blahutová, Šárka; Dvořáčková, Jana; Brát, Radim; Valkovský, Ivo; Hrdličková, Radomíra

doi:10.14712/23362936.2015.13

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Potential hazards include hemolysis, infection, immunosuppression, transfusion-related acute lung injury, and even death. 6,7 Tranexamic acid (TXA) is a synthetic antifibrinolytic agent that binds to the lysine binding site of plasminogen and blocks the binding of plasminogen to the fibrin surface. Thus, plasminogen activation is prevented and fibrinolysis is delayed.…”

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confidence: 99%

Blood Loss and Transfusion After Topical Tranexamic Acid Administration in Primary Total Knee Arthroplasty

Wang¹,

Shen²,

Zeng³

2015

Orthopedics

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There has been much debate and controversy about the safety and efficacy of the topical use of tranexamic acid in primary total knee arthroplasty (TKA). The purpose of this study was to perform a meta-analysis to evaluate whether there is less blood loss and lower rates of transfusion after topical tranexamic acid administration in primary TKA. A systematic review of the electronic databases PubMed, CENTRAL, Web of Science, and Embase was undertaken. All randomized, controlled trials and prospective cohort studies evaluating the effectiveness of topical tranexamic acid during primary TKA were included. The focus of the analysis was on the outcomes of blood loss results, transfusion rate, and thromboembolic complications. Subgroup analysis was performed when possible. Of 387 studies identified, 16 comprising 1421 patients (1481 knees) were eligible for data extraction and meta-analysis. This study indicated that when compared with the control group, topical application of tranexamic acid significantly reduced total drain output (mean difference, -227.20; 95% confidence interval, -347.11 to -107.30; P<.00001), total blood loss (mean difference, -311.28; 95% confidence interval, -404.94 to -217.62; P<.00001), maximum postoperative hemoglobin decrease (mean difference, -0.73; 95% confidence interval, -0.96 to -0.50; P<.00001), and blood transfusion requirements (risk ratios, 0.33; 95% confidence interval, 0.24 to 0.43; P=.14). The authors found a statistically significant reduction in blood loss and transfusion rates when using topical tranexamic acid in primary TKA. Furthermore, the currently available evidence does not support an increased risk of deep venous thrombosis or pulmonary embolism due to tranexamic acid administration. Topical tranexamic acid was effective for reducing postoperative blood loss and transfusion requirements without increasing the prevalence of thromboembolic complications.

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confidence: 99%

Blood Loss and Transfusion After Topical Tranexamic Acid Administration in Primary Total Knee Arthroplasty

Wang¹,

Shen²,

Zeng³

2015

Orthopedics

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“…The most commonly used treatments for acute lung injury are major surgery and prolonged mechanical ventilation, in addition to the use of anti-inflammatory treatments when inflammation develops in response to pneumonia ( 7 , 8 ). It has been demonstrated that acute lung injury is associated with refractory lung disease and the mortality rates of patients with advanced infectious lung injuries are high ( 9 ).…”

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confidence: 99%

Anti-Semaphorin-7A single chain antibody demonstrates beneficial effects on pulmonary inflammation during acute lung injury

et al. 2018

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Pulmonary inflammation is a primary characteristic of lung injury initiated by the accession of immune cells into the alveolar space. Neutrophil migration serves an important role in pulmonary inflammation mediated by the migration of neutrophils into hypoxic tissue sites. The elimination of pulmonary inflammation is directly associated with rehabilitation in patients with lung injury. Anti-inflammatory treatment is essential following lung injury and ultimately determines patient outcomes. Semaphorin-7A (SEMA-7A) is a member of the Semaphorin family that influences the migration of neutrophils into hypoxic tissue sites, thus promoting inflammation. However, understanding of the role of SEMA-7A serves during lung injury is limited and the immunological function of SEMA-7A during the migration of neutrophils into acute injury sites remains unknown. The present study investigated SEMA-7A expression and constructed a single chain antibody for SEMA-7A (Anti-SEMA-7A) to study its therapeutic efficacy against pulmonary inflammation in a mouse model of acute injury sites. The data indicated that the expression of SEMA-7A was upregulated due to induction by pro-inflammatory cytokines and demonstrated that Anti-SEMA-7A inhibited SEMA-7A expression in vitro and in vivo. The current study also indicated that the production of pro-inflammatory cytokines induced by SEMA-7A in endothelial and epithelial cells enhanced pulmonary inflammation. Anti-SEMA-7A suppressed the transendothelial migration of neutrophils mediated by SEMA-7A. Anti-SEMA-7A treatment neutralized SEMA-7A expression and reduced signs of pulmonary inflammation, leading to the elimination of pulmonary inflammation in rat with acute lung injury. The current study identified Anti-SEMA-7A as a potential agent to interfere with the inflammatory pathway during acute lung injury, which may be the basis for anti-inflammatory strategies to treat lung injuries in the future.

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“…It has been reported that the total perioperative blood loss during posterior spinal fusion ranges from 600 to 1500 mL [5][6][7]. Blood transfusion carries a risk of immunological and non-immunological adverse effects and can even increase mortality [8][9][10]. Surgical blood loss is an important component of perioperative total blood loss in major orthopedic surgery.…”

Section: Introductionmentioning

confidence: 99%

Bipolar sealer can reduce intraoperative blood loss and transfusion in major orthopedic surgery: a meta-analysis and trial sequence analysis

Wang¹,

Feng²,

Wang³

et al. 2018

Oncotarget

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To evaluate the efficacy and safety of bipolar sealer for the reduction of intraoperative blood loss and transfusion requirements for patients undergoing major orthopedic surgery, including total knee arthroplasty (TKA), total hip arthroplasty (THA), and spinal surgery. and hemoglobin drop (WMD, -0.14; 95% CI, -0.27-0.00; P = 0.05). There were no significant differences between operation time, the length of the hospital stay and the occurrence of infection (P > 0.05). Compared to standard electrocautery, bipolar sealer can effectively reduce intraoperative blood loss and subsequent blood transfusion without increasing the rate of infections.

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Transfusion-related Acute Lung Injury: Report of Two Cases

Cited by 4 publications

References 19 publications

Blood Loss and Transfusion After Topical Tranexamic Acid Administration in Primary Total Knee Arthroplasty

Blood Loss and Transfusion After Topical Tranexamic Acid Administration in Primary Total Knee Arthroplasty

Anti-Semaphorin-7A single chain antibody demonstrates beneficial effects on pulmonary inflammation during acute lung injury

Bipolar sealer can reduce intraoperative blood loss and transfusion in major orthopedic surgery: a meta-analysis and trial sequence analysis

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