Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2014.55.138
Possible transfusion-related acute lung injury (TRALI) in cardiac surgery patients
Tajana Zah-Bogović
; Department of Anesthesiology, Resuscitation and Intensive Care, University of Zagreb, School of Medicine, Zagreb University Hospital Center, Zagreb, Croatia
Jasna Mesarić
; Agency for Quality and Accreditation in Health Care and Social Welfare, University of Zagreb School of Medicine, Zagreb, Croatia
Pero Hrabač
; Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
Višnja Majerić-Kogler
; University of Zagreb, School of Medicine, Zagreb, Croatia
Sažetak
Aim To determine the incidence of possible transfusionrelated
acute lung injury (TRALI) and related risk factors in
cardiac surgery patients.
Methods A single-center prospective cohort study was
conducted from January 2009 to March 2010 at the Zagreb
University Hospital Center, Croatia. Patient-, transfusion-,
and surgery-related data were collected. The study
included 262 patients who were observed for respiratory
worsening including measurements of arterial oxygen saturation
(SaO2), fraction of inspired oxygen (FiO2), and partial
pressure of arterial oxygen (PaO2). Possible TRALI was
defined according to the Toronto Consensus Conference
definition broadened for 24-hour post-transfusion. This cohort
was divided in two groups. TRALI group included 32
participants with diagnosis of TRALI and the control group
included 220 patients with or without respiratory worsening,
but with no signs of ALI.
Results Possible TRALI was observed in 32 (12.2%) patients.
Compared with the control group, possible TRALI patients
had higher American Association of Anesthesiology scores,
higher rate of respiratory comorbidity (43.8% vs 15.5%), and
required more red blood cells (median 4, range [2.5-6] vs 2
[1-3]), plasma (5 [0-6] vs 0 [0-2]), and platelet units (0 [0-8]
vs 0 [0-0]) (P < 0.001 all). Risk factors for possible TRALI were
total number of transfused blood units (odds ratio [OR]
1.23; 95% confidence interval [CI] 1.10-1.37) and duration of
cardiopulmonary bypass (OR 1.08; 95% CI 1.05-1.11). Posttransfusion
PaO2/FiO2 ratio was significantly decreased in
possible TRALI patients and significantly increased in transfused
controls without acute lung injury.
Conclusion We observed a higher rate of possible TRALI
cases than in other studies on cardiac surgery patients. Serial
monitoring of PaO2/FiO2 ratio and detection of its posttransfusion
worsening aids in identification of possible
TRALI cases.
Ključne riječi
Hrčak ID:
127308
URI
Datum izdavanja:
15.4.2014.
Posjeta: 968 *