Transfusion-related acute lung injury
From IDWiki
Background
- Respiratory syndrome with hypoxia and bilateral CXR infiltrates associated with blood transfusion
- Mostly with RBCs, platelets, or plasma, but can rarely happen after cryoprecipitate or IVIg
- Occurs within 6 hours of transfusion, with no evidence of heart failure
- Occurs in about 1 in 10,000 transfusion
- Mortality is 5 to 10%
- Unclear pathophysiology
Clinical Manifestations
- Onset usually within 1 to 2 hours of transfusion, but may be up to 6 hours
- Dyspnea and hypoxia
- Bilateral infiltrates on chest x-ray
- Presents similarly to ARDS
- Usually resolves within 24 to 72 hours
Management
- Stop transfusion
- Supportive care; often requires mechanical ventilation
- Diuretics and steroids not helpful
