Transfusion-related acute lung injury: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
{{TRALI vs TACO}} | |||
==Management== | ==Management== |
Revision as of 21:03, 4 February 2016
Background
- Due to granulocyte recruitment and degranulation within the lung
- More common with FFP and platelet transfusions (extremely rare with pRBC transfusion alone)
- pRBCs do contain residual plasma and can have TRALI
Clinical Features
- Time Frame: abrupt to within 6 hours of transfusion initiation
- ARDS-like symptoms
Differential Diagnosis
Transfusion Reaction Types
- Acute
- Delayed
Acute allergic reaction
- Allergic reaction/urticaria
- Anaphylaxis
- Angioedema
- Anxiety attack
- Asthma exacerbation
- Carcinoid syndrome
- Cold urticaria
- Contrast induced allergic reaction
- Scombroid
- Shock
- Transfusion reaction
Diagnosis
TRALI vs TACO
TRALI | TACO | |
Onset | Acute, within 6hrs | Often more gradual |
BP | Low | High |
Temp | Febrile | Normal |
JVD/pedal edema | Unlikely | Likely |
CVP/PAWP | Normal | Elevated |
BNP | Normal | Elevated |
Resp | Dyspneic | Dyspneic |
CXR | B/l infiltrates | B/l infiltrates |
Management
- Strop transfusion
- Treat like ARDS
- Avoid diuresis
Disposition
- Bilateral pulmonary infiltrates due to noncardiogenic pulmonary edema within 6h of transfusion