Transfusion-related acute lung injury

Revision as of 01:31, 18 March 2016 by Rossdonaldson1 (talk | contribs) (References)

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 allergic 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

See Also

External Links

References