Transfusion-related acute lung injury
Contents
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
- 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
- Time Frame: abrupt to within 6 hours of transfusion initiation
Management
- Strop transfusion
- Treat like ARDS
- Avoid diuresis
Disposition
- Bilateral pulmonary infiltrates due to noncardiogenic pulmonary edema within 6h of transfusion