Long-Term Survival and Quality of Life After Transfusion-Associated Pulmonary Edema in Critically III Medical Patients

Li, Guangxi; Kojičić, Marija; Reriani, Martin; Pérez, Evans R. Fernández; Thakur, Lokendra; Kashyap, Rahul; Buskirk, Camille M. van; Gajić, Ognjen

doi:10.1378/chest.09-0841

Cited by 57 publications

(43 citation statements)

References 48 publications

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“…Transfusion-related acute lung injury (TRALI) is a major cause of morbidity after blood transfusion, and it is the leading cause of transfusion-associated mortality reported to the US FDA [25,26]. It has a reported incidence of 1 in 5,000 blood products transfused but is likely to be significantly more common due to low recognition and underreporting [27].…”

Section: Transfusion-related Acute Lung Injurymentioning

confidence: 99%

Dyspnea and Reversibility of Antiplatelet Agents: Ticagrelor, Elinogrel, Cangrelor, and Beyond

2013

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Context: Oral reversible platelet P2Y12 receptor inhibitors (ticagrelor and elinogrel) cause double-digit rates of dyspnea, while irreversible oral antiplatelet drugs (aspirin, ticlopidoine, clopidogrel, and prasugrel) or intravenous glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, or tirofiban) do not increase the incidence of dyspnea in randomized trials. Dyspnea after oral reversible antiplatelet agents remains unexplained. A transfusion-related acute lung injury (TRALI) hypothesis has been proposed. The dyspnea risks after cangrelor, an intravenous reversible antiplatelet agent, are not well defined but may offer a universal mechanism linking TRALI, dyspnea, and reversible platelet inhibition. Objective: We analyzed safety data from recent head-to-head randomized trials with reversible antiplatelet agents (ticagrelor, elinogrel, and cangrelor) compared to irreversible (clopidogrel/placebo) comparators. Results: All three reversible antiplatelet agents cause excess dyspnea. In contrast to the high double-digit rates after oral ticagrelor or elinogrel, the dyspnea risks after intravenous cangrelor were smaller (<2%) but still consistently and significantly higher than in the corresponding control arms. Conclusions: The clinical utility of reversible antiplatelet strategies has been challenged. Despite a potential advantage of fewer bleeding events during heart surgery, reversible antiplatelet agents carry the risk of potential autoimmune reactions manifesting as dyspnea. Repeated binding and unbinding cycles, impaired platelet turnover, and lung sequestration or apoptosis of overloaded destructive platelets are among the potential mechanism(s) responsible for dyspnea after reversible antiplatelet agents.

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Section: Transfusion-related Acute Lung Injurymentioning

confidence: 99%

Dyspnea and Reversibility of Antiplatelet Agents: Ticagrelor, Elinogrel, Cangrelor, and Beyond

2013

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“…Concerns regarding nosocomial infections [7][8][9] and transfusion-associated lung injury and circulatory overload 10,11 have directed the efforts toward evaluating the indications for transfusion and exploring alternative methods of blood conservation. However, it is unclear whether changes in blood-management practices have led to a change in allogenic blood-transfusion rates in the U.S. during the past decade.…”

mentioning

confidence: 99%

Allogenic Blood Transfusion Following Total Hip Arthroplasty: Results from the Nationwide Inpatient Sample, 2000 to 2009

Saleh

Small

Pillai

et al. 2014

The Journal of Bone and Joint Surgery

124

112

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“…On the other hand, there is some scientifi c evidence that in patients in severe condition TRALI is an independent predictor of mortality, a prolonged hospital stay and reduced survival rate. It does not, however, affect the quality of life assessed by the SF-36 Health Survey one year after discharge from the hospital [40].…”

Section: Prognosismentioning

confidence: 91%

Transfusion-related acute lung injury: A dangerous and underdiagnosed noncardiogenic pulmonary edema

Jaworski¹,

Maślanka

Kosior³

2013

Cardiol J

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Transfusion-related acute lung injury (TRALI) is one of the leading causes of death associated with transfusion of blood and blood components. The understanding of the etiology and pathophysiology of this syndrome has much improved during the last decades, nevertheless numerous issues are still unresolved and symptomatic treatment remains the cornerstone of medical management. Consequently more attention is directed at primary as well as secondary prevention. The awareness of the problem within the medical society is still unsatisfactory which results in a high number of unrecognized cases or of inaccurate diagnoses one of which is cardiogenic pulmonary edema. The aim of this review is to make the TRALI syndrome morefamiliar to clinicians and to emphasize how signifi cant proper medical management is both for the patients presenting TRALI symptoms as well as for future recipients of blood components. (Cardiol J 2013; 20, 4: 337-344)

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Long-Term Survival and Quality of Life After Transfusion-Associated Pulmonary Edema in Critically III Medical Patients

Abstract: In critically ill medical patients, development of TRALI, but not TACO, is independently associated with decreased long-term survival.

Cited by 57 publications

References 48 publications

Dyspnea and Reversibility of Antiplatelet Agents: Ticagrelor, Elinogrel, Cangrelor, and Beyond

Dyspnea and Reversibility of Antiplatelet Agents: Ticagrelor, Elinogrel, Cangrelor, and Beyond

Allogenic Blood Transfusion Following Total Hip Arthroplasty: Results from the Nationwide Inpatient Sample, 2000 to 2009

Transfusion-related acute lung injury: A dangerous and underdiagnosed noncardiogenic pulmonary edema

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