Transfusion Related Acute Lung Injury in Cardiac Surgery

Abstract

Transfusion related acute lung injury (TRALI) is an uncommon complication following administration of blood products. It is often difficult to differentiate from other commoner causes of cardio-respiratory instability. However, prompt diagnosis and management is associated with favorable outcome.

Transfusion-related acute lung injury in cardiac surgery

“…Twelve studies were included in the qualitative synthesis. Eight of them [16][17][18][19][20][21][22][23] were case reports, while the others were case-control [24] prospective cohort [25] and randomized-controlled trials. [26,27] Trials were at a level of IIb according to the definition of 'levels of evidence'.…”

“…Blood transfusion was determined as one of the main risk factors for new-onset of atrial fibrillation, [29] development of infections, [30] prolonged mechanical ventilation, [31,32] acute renal injury, [31] decreased quality of life, [33] mortality, [33][34][35][36] and ARDS. [16][17][18][19][20][21][22][23] The records of ARDS mainly encompass the case reports. [16][17][18][19][20][21][22][23] Although 56.4% of patients needed blood transfusion in the first 72 hours of postoperative period [34] and transfusion increased the pulmonary morbidity [25] in cardiac surgery patients as well, it is obvious that TRALI has not been adequately investigated in prospective trials.…”

“…[16][17][18][19][20][21][22][23] The records of ARDS mainly encompass the case reports. [16][17][18][19][20][21][22][23] Although 56.4% of patients needed blood transfusion in the first 72 hours of postoperative period [34] and transfusion increased the pulmonary morbidity [25] in cardiac surgery patients as well, it is obvious that TRALI has not been adequately investigated in prospective trials.…”

“…[16][17][18][19][20][21][22][23] The leading cause of TRALI was described as FFP. [17][18][19]21,22] In addition to FFP, cases due to transfusion of platelet and RBC alone were also reported. [16,23] Singh and Zeltsman [23] performed blood transfusion intraoperatively, while the others used blood products postoperatively.…”

Acute Transfusion-Associated Lung Injury

“…В боль шинстве случаев своевременная постановка диагноза и проведе ние адекватной терапии сопровождаются благоприятным кли ническим исходом. У 80% больных с TRALI в течение 72 часов наблюдается обратное развитие симптоматики, без морфологи ческих изменений со стороны легких [41]. Однако при тяжелом течении летальность может составить 5-15% [4,18].…”