Acute Transfusion-Associated Lung Injury in Cardiosurgical Patients

Карпун, Н. А.; Мороз, В. В.; Afonin, A. N.; Хренов, Ю. В.; Фитилев, Д. Б.

doi:10.15360/1813-9779-2008-3-23

rmt

2008

DOI: 10.15360/1813-9779-2008-3-23

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Acute Transfusion-Associated Lung Injury in Cardiosurgical Patients

Н. А. Карпун¹,

В. В. Мороз²,

A. N. Afonin³

et al.

Abstract: О с т р о е п о в р е ж д е н и е л ё г к и х Цель работы-изучить распространение острого повреждения легких, ассоциированного с трансфузией компо нентов донорской крови (TRALI), среди пациентов отделения кардиохирургической реанимации, оценка вклада данной патологии в общее количество послеоперационных легочных осложнений и влияние на течение и исход ос новного заболевания. Материал и методы. Ретроспективно обследованы 515 больных, оперированных в ГВКГ им. Н. Н. Бурденко по поводу патологии сердечно сосудисто… Show more

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Cited by 3 publications

References 12 publications

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The case of successful treatment of severe TRALI-syndrome developed after ART program

Sagamonova¹,

Казанцева²,

Zolotykh³

et al. 2017

Probl. reprod.

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Представлен успешный случай лечения пациентки с диагнозом бесплодия, которой по медицинским показаниям была проведена трансвагинальная пункция в программе экстракорпорального оплодотворения (ЭКО), осложнившаяся внутрибрюшным кровотечением, что потребовало лапароскопической коррекции, с последующим развитием ТRALI-синдрома после гемотрансфузии. Острое посттрансфузионное повреждение легких (TRALI-Transfuion related acute lung injuri)острое повреждение легких, связанное с трансфузией. По определению Национального института сердца, легких и крови США, под термином TRALI понимают «остро возникающую гипоксемию в первые 6 ч после гемотрансфузии, при необязательном развитии инфильтратов в легких и отсутствии левожелудочковой недостаточности или других причин развития отека легких» [1]. Отмечено, что развитие этого грозного осложнения всегда связано с трансфузией крови и ее компонентов: чаще всего-свежезамороженной плазмы (СЗП), реже-эритроцитной массы,

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The case of successful treatment of severe TRALI-syndrome developed after ART program

Sagamonova¹,

Казанцева²,

Zolotykh³

et al. 2017

Probl. reprod.

View full text Add to dashboard Cite

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TRALI and TACO syndrome. Pathophysiology, diagnosis and treatment: a review

Yaroshetskiy,

Savko,

Zhigulin

2024

Annals of Critical Care

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INTRODUCTION: TRALI (transfusion-related acute lung injury) and TACO (transfusion-associated circulatory overload) are severe post-transfusion reactions with high hospital mortality, uncertainty in pathophysiologic mechanisms and a blurred clinical presentation often lead to these conditions being underdiagnosed or missed by clinicians. OBJECTIVE: To analyze and summarize the current understanding of the pathophysiology, differential diagnosis and treatment of TRALI and TACO syndrome. To highlight the best approaches and current practices to improve treatment efficacy and awareness among specialists. MATERIALS AND METHODS: Articles in the following databases were analyzed: PubMed, eLibrary. The main inclusion criteria were: free access to the full content of the publications, compliance with the review topics concerning pathophysiology, diagnosis and treatment of TRALI- and TACO-syndrome. Exclusion criteria: abstracts, conference proceedings and editorial letters, as well as publications not indexed in specialized abstract databases. RESULTS: This article presents the main reference points, thanks to which clinicians can make a differential diagnosis among posttransfusion complications and select the optimal treatment. Since TACO is a simulated cardiogenic pulmonary edema as a result of altered cytokine profile, and TRALI-syndrome is a consequence of specific immunologic conflict between donor and recipient after hemotransfusion, these conditions should be differentiated in the inpatient setting, and specialists should use the full range of modern laboratory and instrumental methods. CONCLUSIONS: Despite a large number of studies, the pathophysiologic mechanisms of TRALI and TACO remain somewhat unclear, and current approaches to diagnosis and treatment are not effective. Therefore, the existing gaps in the diagnostics of posttransfusion reactions should be clarified in further studies, and clinicians should be extra vigilant in their choice of diagnosis.

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Noninvasive ventilation outside the intensive care unit for respiratory rehabilitation after on-pump cardiac surgery: a prospective randomized controlled trial

Dvoryadkin,

Polyakov,

Belyakova

et al. 2024

Physical and rehabilitation medicine, medical rehabilitation

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Background: сardiac surgery with cardiopulmonary bypass (CPB) is associated with a high risk of postoperative respiratory complications. Perioperative damage to the lungs due to ischemia and reperfusion, mechanical ventilation, trauma, etc., on the one hand, is a trigger for aseptic inflammation in the lungs, on the other hand, it makes compromised lungs an easy target for infection. Actively developed methods of “protecting” of the lungs, protective lungs ventilation, etc. are limited to the perioperative and “resuscitation” stages and do not exhaust the entire range of respiratory support, in particular, required in the later stages of postoperative hospitalization, which dictates the need to search for methods of respiratory rehabilitation even after transfer from the intensive care unit. Aims: evaluate the effectiveness of respiratory rehabilitation of cardiosurgical patients using non-invasive mask lung ventilation (NIMLV) performed outside the intensive care unit (ICU), compared with standard breathing exercises. Materials and methods: A prospective, randomized, single-center study included 60 patients aged 62±12 years after cardiac surgery with CPB (86±17 min) with bypass grafting of 2±1 coronary arteries, aged 62±12 years, who required mechanical lung ventilation for more than 6 hours after surgery. After transfer from the ICU, patients in the control group (n=30) underwent standard respiratory rehabilitation; patients in the main group (n=30) additionally received four sessions of NIMLV. Results: Patients in the main group had a more rapid recovery of respiratory function, which made it possible to reduce the time of postoperative hospitalization (10 (8; 15)) in comparison with the standard group (14 (13; 20)). Conclusions: The use of NIMLV outside the ICU in addition to the standard respiratory activation protocol is safe and allows you to speed up the process of respiratory rehabilitation, reduce the duration of postoperative hospitalization of patients after coronary bypass surgery.

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Acute Transfusion-Associated Lung Injury in Cardiosurgical Patients

Cited by 3 publications

References 12 publications

The case of successful treatment of severe TRALI-syndrome developed after ART program

The case of successful treatment of severe TRALI-syndrome developed after ART program

TRALI and TACO syndrome. Pathophysiology, diagnosis and treatment: a review

Noninvasive ventilation outside the intensive care unit for respiratory rehabilitation after on-pump cardiac surgery: a prospective randomized controlled trial

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