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- Title
Transfusion-related acute lung injury in ICU patients admitted with gastrointestinal bleeding.
- Authors
Benson, Alexander B.; Austin, Gregory L.; Berg, Mary; McFann, Kim K.; Thomas, Sila; Ramirez, Gina; Rosen, Hugo; Silliman, Christopher C.; Moss, Marc
- Abstract
Purpose: Transfusion of blood components is common in patients admitted to the intensive care unit (ICU) for gastrointestinal (GI) bleeding, yet the incidence and risk factors for development of transfusion-related acute lung injury (TRALI) in these patients are unknown. Methods: Patients admitted to a medical ICU for GI bleeding ( n = 225) were analyzed for patient- and transfusion-specific risk factors for development of TRALI. Results: In transfused patients ( n = 150), the incidence of TRALI was 15% [95% confidence interval (CI), 10-21%] and accounted for 76% (22/29) of all acute lung injury (ALI) cases. Transfused patients with end-stage liver disease (ESLD) ( n = 72) developed TRALI more frequently than those without ESLD (29% versus 1%, p < 0.01). Fresh frozen plasma (FFP) was temporally associated with TRALI in 86% of cases. Transfusion-specific risk factors for development of TRALI included number of transfused units of FFP and nonleukoreduced red blood cells. Patient-specific risk factors included Model for End-Stage Liver Disease (MELD) score, admission serum albumin level, and presence of ALI risk factors. Conclusions: TRALI is common in critically ill ESLD patients with gastrointestinal bleeding. Nonleukoreduced red blood cells and FFP are significant transfusion-specific risk factors and their use should be re-evaluated in bleeding patients with ESLD.
- Subjects
BLOOD transfusion; LUNG injuries; GASTROINTESTINAL diseases; INTENSIVE care units; DISEASE risk factors; LIVER diseases; BLOOD cells; PATIENTS
- Publication
Intensive Care Medicine, 2010, Vol 36, Issue 10, p1710
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-010-1954-x