Complications pulmonaires de la transfusion (TACO–TRALI)

Renaudier, P.; Rebibo, Danielle; Waller, C.; Schlanger, S.; Vo, Mai-Phuong; Ounnoughène, N.; Breton, Pascal; Chèze, Stéphane; Girard, Albane; Hauser, Lisette; Legras, Jean; Saillol, Anne; Willaert, Béatrice; Caldani, C.

doi:10.1016/j.tracli.2009.04.008

Cited by 22 publications

(10 citation statements)

References 91 publications

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“…The third and last measure refers to the avoidance of unnecessary transfusions. [13,18,21,22] The case presented in this article fully confirms the theory of the "two-hit" model. In particular, the impaired state of the patient combined with the last PLT transfusion resulted in TRALI.…”

Section: Discussionsupporting

confidence: 79%

Case study of transfusion related acute lung injury in intensive care unit

Margari

Bompou–Magoula

2015

JNEP

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Transfusion is a common method of treatment of haemorrhagic events of patients treated in the Intensive Care Unit (ICU). Nonetheless, it involves various dangers, in many cases fatal, such as transfusion related acute lung injury (TRALI). This article refers to the case encountered during our traineeship in the ICU. It is about a 47-year-old man, who was transported to us from another tertiary acute care facility intubated due to diabetic coma. After 39 days of treatment in the ICU, the acute diabetes mellitus, the hemodynamic instability and the electrolyte disorders were regulated. However, he started to have diffuse haemorrhagic events due to intestinal necrosis and required transfusion of blood factors. After the transfusion of Platelets (PLT) he developed Acute Respiratory Distress Syndrome (ARDS), which evolved to TRALI and finally the death of the patient occurred.

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Section: Discussionsupporting

confidence: 79%

Case study of transfusion related acute lung injury in intensive care unit

Margari

Bompou–Magoula

2015

JNEP

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“…Treatment of transfusion-associated circulatory overload is familiar to most medical interns, and includes elevation of the head of the bed, administration of oxygen, intravenous diuretics, and the use of nitrates or other vasodilators. 18 Although most patients recover with appropriate treatment, in-hospital mortality may be increased 3,17,20 and duration of ICU and hospital stays are prolonged. 3,14 In this study, patients with pre-existing congestive heart failure and chronic renal failure, and who received more blood products or had a positive fluid balance, were at increased risk of transfusion-associated circulatory overload.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that infusion rate may be more important than total volume of blood transfused. 8,18 Host factors are probably more important than infusion practice. Patients aged younger than 3 years and older than 60 years are reported to be at increased risk.…”

mentioning

confidence: 99%

Risk Factors and Outcomes in Transfusion-associated Circulatory Overload

Murphy

Kwaan

Looney

et al. 2013

The American Journal of Medicine

111

126

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BACKGROUND Transfusion-associated circulatory overload is characterized by new respiratory distress and hydrostatic pulmonary edema within 6 hours after blood transfusion, but its risk factors and outcomes are poorly characterized. METHODS Using a case control design, we enrolled 83 patients with severe transfusion-associated circulatory overload identified by active surveillance for hypoxemia and 163 transfused controls at the University of California, San Francisco (UCSF) and Mayo Clinic (Rochester, Minn) hospitals. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression, and survival and length of stay were analyzed using proportional hazard models. RESULTS Transfusion-associated circulatory overload was associated with chronic renal failure (OR 27.0; 95% CI, 5.2–143), a past history of heart failure (OR 6.6; 95% CI, 2.1–21), hemorrhagic shock (OR 113; 95% CI, 14.1–903), number of blood products transfused (OR 1.11 per unit; 95% CI, 1.01–1.22), and fluid balance per hour (OR 9.4 per liter; 95% CI, 3.1–28). Patients with transfusion-associated circulatory overload had significantly increased in-hospital mortality (hazard ratio 3.20; 95% CI, 1.23–8.10) after controlling for Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score, and longer hospital and intensive care unit lengths of stay. CONCLUSIONS The risk of transfusion-associated circulatory overload increases with the number of blood products administered and a positive fluid balance, and in patients with pre-existing heart failure and chronic renal failure. These data, if replicated, could be used to construct predictive algorithms for transfusion-associated circulatory overload, and subsequent modifications of transfusion practice might prevent morbidity and mortality associated with this complication.

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“…Other important complications relate to blood immunogenicity, increasingly recognized over the past two decades, particularly transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload [33,34]. TRALI is the commonest cause of transfusion-related death [33,34].…”

Section: Plasma Basicsmentioning

confidence: 99%

“…TRALI is the commonest cause of transfusion-related death [33,34]. Two mechanisms have mostly been implicated in TRALI.…”

Section: Plasma Basicsmentioning

confidence: 99%

Clinical review: Fresh frozen plasma in massive bleedings - more questions than answers

et al. 2010

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Fresh frozen plasma (FFP) is indicated for the management of massive bleedings. Recent audits suggest physician knowledge of FFP is inadequate and half of the FFP transfused in critical care is inappropriate. Trauma is among the largest consumers of FFP. Current trauma resuscitation guidelines recommend FFP to correct coagulopathy only after diagnosed by laboratory tests, often when overt dilutional coagulopathy already exists. The evidence supporting these guidelines is limited and bleeding remains a major cause of trauma-related death. Recent studies demonstrated that coagulopathy occurs early in trauma. A novel early formula-driven haemostatic resuscitation proposes addressing coagulopathy early in massive bleedings with FFP at a near 1:1 ratio with red blood cells. Recent retrospective reports suggest such strategy significantly reduces mortality, and its use is gradually expanding to nontraumatic bleedings in critical care. The supporting studies, however, have bias limiting the interpretation of the results. Furthermore, logistical considerations including need for immediately available universal donor AB plasma, short life after thawing, potential waste and transfusion-associated complications have challenged its implementation. The present review focuses on FFP transfusion in massive bleeding and critically appraises the evidence on formula-driven resuscitation, providing resources to allow clinicians to develop informed opinion, given the current deficient and conflicting evidence.

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Complications pulmonaires de la transfusion (TACO–TRALI)

Cited by 22 publications

References 91 publications

Case study of transfusion related acute lung injury in intensive care unit

Case study of transfusion related acute lung injury in intensive care unit

Risk Factors and Outcomes in Transfusion-associated Circulatory Overload

Clinical review: Fresh frozen plasma in massive bleedings - more questions than answers

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