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Journal of Intensive Care Medicine, Vol. 23, No. 2, 109-121 (2008)
DOI: 10.1177/0885066607312994

Transfusion-Related Acute Lung Injury

Randeep S. Jawa, MD

Department of Surgery, SUNY Buffalo, Buffalo General Hospital, Buffalo, New York, rjawa{at}unmc.edu

Sergio Anillo, MD

Department of Surgery, SUNY Buffalo, Buffalo General Hospital, Buffalo, New York

Mahmoud N. Kulaylat, MD

Department of Surgery, SUNY Buffalo, Buffalo General Hospital, Buffalo, New York

Transfusion-related acute lung injury (TRALI) refers to a clinical syndrome of acute lung injury that occurs in a temporal relationship with the transfusion of blood products. Because of the difficulty in making its diagnosis, TRALI is often underreported. Three not necessarily mutually exclusive hypotheses have been described to explain its etiogenesis: antibody mediated, non-antibody mediated, and two hit mechanisms. Treatment is primarily supportive and includes supplemental oxygen. Diuretics are generally not indicated, as hypovolemia should be avoided. Compared with many other forms of acute lung injury, including the acute respiratory distress syndrome, TRALI is generally transient, reverses spontaneously, and carries a better prognosis. A variety of prevention strategies have been proposed, ranging from restrictive transfusion strategies to using plasma derived only from males.

Key Words: transfusion-related acute lung injury • transfusion • lung injury • pulmonary edema


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