Possible transfusion-related acute lung injury TRALI in cardiac surgery patientsReportar como inadecuado

Possible transfusion-related acute lung injury TRALI in cardiac surgery patients - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Croatian medical journal, Vol.55 No.2 April 2014. -

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.

Autor: Tajana Zah-Bogović - ; Department of Anesthesiology, Resuscitation and Intensive Care, University of Zagreb, School of Medicine,

Fuente: http://hrcak.srce.hr/


Documentos relacionados