Transfusion related acute lung injury with massive pulmonary secretion during cardiac surgery. A case report

Teodori, Julien; Rampersad, Kamal A.; Teodori, Giovanni; Roopchand, Roland; Angelini, Gianni

doi:10.1186/1749-8090-9-64

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…[ 16 ] It is clinically defined as a new acute lung injury (ALI) with the onset of symptoms or signs within 6 h of a transfusion. TRALI is usually temporary, and supportive care mostly leads to a recovery of the SaO 2 to the level before the transfusion within 48–96 h.[ 17 ] The related clinical aspects were reported by Teodori et al[ 4 ] in a case report of TRALI with massive pulmonary secretions similar to the respiratory manifestations in our case.…”

Section: Discussionsupporting

confidence: 68%

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Trauma induced capillary leak syndrome after penetrating chest injury: Manifestation of massive ascites and pulmonary secretions aggravated by transfusion

Youn¹

2020

Ulus Travma Acil Cerrahi Derg

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Trauma with prolonged shock can cause systemic capillary leak syndrome regardless of the site of injury and a transfusion can aggravate it. The systemic capillary leak induces both an abdominal compartment syndrome and pulmonary edema, and a transfusion can aggravate these sequelae within hours. In our case, 21-year-old man with a penetrating injury in his left thorax experienced delay in rescue and definitive surgery. To manage life-threatening shock, massive blood transfusion and crystalloids had been infused. Cardiopulmonary cerebral resuscitations were performed 2 times during the surgery. Massive amount of pulmonary secretions emitted from his airways with severe hypoxia along with development of massive ascites causing abdominal compartment syndrome, while the surgery was underway. After temporary abdominal closure, he was moved to the intensive care unit and underwent venovenous extracorporeal membranous oxygenation. He recovered without any notable complications. It is important to prevent and correct the shock rapidly by appropriate rescue, controlling the source and infusing less amount of crystalloid and transfusion.

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Section: Discussionsupporting

confidence: 68%

“…[ 2 , 3 ] During this process, abdominal compartment syndrome (ACS) and pulmonary edema can progress with fatal results, especially in case of pulmonary edema, because transfusion related acute lung injury (TRALI) which is a rare complication of transfusion can aggravate it with pulmonary capillary leak. [ 4 – 6 ]…”

Section: Introductionmentioning

confidence: 99%

Trauma induced capillary leak syndrome after penetrating chest injury: Manifestation of massive ascites and pulmonary secretions aggravated by transfusion

Youn¹

2020

Ulus Travma Acil Cerrahi Derg

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“…TRALI can occur with all blood components, including plasma, platelets, and intravenous immunoglobulin (IVIG) (8,9). Other causes of pulmonary edema should be excluded within TRALI diagnosis, and ARDS, pneumonia, heart failure, volume overload, and acute hemolytic reactions must be considered in differential diagnosis (12, 13).…”

Section: Discussionmentioning

confidence: 99%

TRALI Syndrome During the Treatment of a Plasmodium falciparum Malaria Case

Çaşkurlu

Nurmuhammedov²,

Htway³

2017

TurkiyeParazitolDerg

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“…However, detection may be difficult in cases where it occurs during cardiopulmonary bypass (CPB) due to the lack of sufficient information. Although TRALI occurrence during cardiac surgery has been reported [ 3 , 4 ], few clinical reports have addressed cases of TRALI associated with derangements in CPB operations. Here, we report a case of massive pulmonary secretions during CPB, probably induced by TRALI type II.…”

Section: Introductionmentioning

confidence: 99%

Anesthetic Management of a Patient With Massive Pulmonary Secretion During Cardiopulmonary Bypass Probably Due to Transfusion-Related Acute Lung Injury Type Ⅱ

Watanabe¹,

Miyagi²,

Kaneda³

2023

Cureus

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Transfusion-related acute lung injury (TRALI) is potentially life-threatening adverse reaction associated with blood transfusion and can induce perioperative pulmonary secretion. TRALI that develops during cardiopulmonary bypass (CPB) may be difficult to detect; however, the pathophysiology might manifest as derangements in CPB operations. A 79-year-old man was scheduled to undergo partial replacement of the aortic arch with CPB. Two units of red blood cells were loaded into the priming solution. Although the vital signs, including oxygenation, remained stable in the prebypass period, perfusionists noticed a decreasing trend in the venous reservoir level early in the CPB operations. The trend continued even during circulatory arrest with selective cerebral perfusion, resulting in the termination of the modified hemofiltration. Surgical procedures were accomplished uneventfully; however, a large amount of fluid was required to maintain the minimal reservoir level and CPB flow. The total fluid balance during CPB was +8,233 mL, which was quite unusual in our practice. When 800 mL of massive pulmonary secretion was detected before CPB withdrawal, the etiology could not be determined simultaneously; nonetheless, systemic vascular hyperpermeability was speculated to be the underlying pathophysiology. Our therapeutic approach following the treatment of acute respiratory distress syndrome contributed to halting the deterioration of lung injury. Although the pneumothorax developed on the first postoperative day, the patient was treated with the insertion of a chest drainage tube. Subsequently, the patient had a good course and was discharged without respiratory complications. In conclusion, massive pulmonary secretion, probably due to TRALI type II, was associated with derangements in CPB operations. Prompt identification of the underlying pathophysiology and appropriate intervention is crucial.

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Transfusion related acute lung injury with massive pulmonary secretion during cardiac surgery. A case report

Cited by 7 publications

References 10 publications

Trauma induced capillary leak syndrome after penetrating chest injury: Manifestation of massive ascites and pulmonary secretions aggravated by transfusion

Trauma induced capillary leak syndrome after penetrating chest injury: Manifestation of massive ascites and pulmonary secretions aggravated by transfusion

TRALI Syndrome During the Treatment of a Plasmodium falciparum Malaria Case

Anesthetic Management of a Patient With Massive Pulmonary Secretion During Cardiopulmonary Bypass Probably Due to Transfusion-Related Acute Lung Injury Type Ⅱ

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