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  • Transfusion-related acute lung injury: report of a clinical look-back investigation
  • Kopko PM; Marshall CS; MacKenzie MR; Holland PV; Popovsky MA
  • JAMA 2002[Apr]; 287 (15): 1968-71
  • CONTEXT: Transfusion-related acute lung injury (TRALI) is a syndrome that includes dyspnea, hypotension, bilateral pulmonary edema, and fever. TRALI is the third leading cause of transfusion-related mortality, but it is probably underdiagnosed and underreported. OBJECTIVE: To determine if blood products from a frequent plasma donor, whose blood product was implicated in a fatal case of TRALI, caused symptoms of TRALI in other recipients of her plasma. DESIGN, SETTING, AND PARTICIPANTS: Retrospective chart review (conducted from November 2000 through April 2001) of 50 patients who received blood components within 2 years (October 1998 through October 2000) from a donor linked to a transfusion-related fatality. MAIN OUTCOME MEASURE: Occurrence of mild/moderate (dyspnea with fever, chills, hypotension, and/or hypoxemia) or severe (acute pulmonary edema or need for mechanical ventilation) reaction associated with transfusion. RESULTS: Superimposed illness prevented assessment of TRALI in 14 patients. Of the 36 patient charts that could be reviewed, 7 mild/moderate reactions were reported in 6 patients (16.7%) and 8 severe reactions were reported in 8 patients (22.2%). Of 5 patients who received multiple transfusions from the same donor, 2 experienced 2 reactions: one had 2 mild/moderate reactions and the other had both a mild/moderate and a severe reaction. While 5 of the 7 mild/moderate reactions were reported to the hospital transfusion service, only 2 of the 8 severe reactions were reported. Only 2 reactions (1 mild/moderate and 1 severe) were reported to the regional blood collection facility. CONCLUSIONS: TRALI was frequently underdiagnosed and underreported in recipients of blood products from a donor whose blood products may have caused TRALI in several transfusion recipients. Clinical education and awareness of this often-overlooked diagnosis are imperative for appropriate prevention and treatment.
  • |*Transfusion Reaction[MESH]
  • |Acute Disease[MESH]
  • |Blood Donors[MESH]
  • |Contact Tracing[MESH]
  • |Dyspnea/etiology[MESH]
  • |Fever/etiology[MESH]
  • |Humans[MESH]
  • |Hypotension/etiology[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Plasma[MESH]
  • |Pulmonary Edema/etiology[MESH]
  • |Respiratory Distress Syndrome, Adult/*diagnosis/epidemiology/*etiology[MESH]
  • |Retrospective Studies[MESH]





  • *{{pmid11960539}}
    *<b>[http://www.kidney.de/mlpefetch.php?search=11960539 Transfusion-related acute lung injury: report of a clinical look-back investigation ]</b> JAMA 2002; 287(15) ; 1968-71 Kopko PM; Marshall CS; MacKenzie MR; Holland PV; Popovsky MA

        *11960539*

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    JAMA

    1968 15.287 2002