Transfusion-related Pulmonary Complications

  • A. D. Goldberg
  • L. Clifford
  • D. J. Kor
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM, volume 2012)

Abstract

Physicians have long recognized, though incompletely understood, the respiratory symptoms their patients may manifest after receiving a blood product transfusion [1, 2]. Today, two distinct pulmonary transfusion reactions are recognized as the likely etiology. Although both share a similar clinical phenotype of pulmonary edema and hypoxemic respiratory insufficiency, each have different management schemes and preventative strategies [3–6]. One reaction, called transfusionrelated acute lung injury (TRALI) is a life-threatening complication marked by acute inflammation and injury to the pulmonary parenchyma and vasculature with resultant alveolar flooding. The second, transfusion-associated circulatory overload (TACO) results from the compensatory capacity of the cardiovascular system being overwhelmed by an increase in intravascular volume. This overloaded state manifests as respiratory distress from hydrostatic pulmonary edema.

Keywords

Pulmonary Edema Acute Lung Injury Prothrombin Complex Concentrate Transfusion Reaction Intravascular Volume Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Tung CL, Bien WN, Ch’u YC, Wang SH, Ma WS (1937) Chin Med J 52: 479Google Scholar
  2. 2.
    Barnard RD (1951) Indiscriminate transfusion: a critique of case reports illustrating hypersensitivity reactions. N Y State J Med 51: 2399–2402Google Scholar
  3. 3.
    Lin Y, Saw CL, Hannach B, Goldman M (2012) Transfusion-related acute lung injury prevention measures and their impact at Canadian Blood Services. Transfusion (in press)Google Scholar
  4. 4.
    Gajic O, Rana R, Winters JL, et al (2007) Transfusion-related acute lung injury in the critically ill, prospective nested case-control study. Am J Respir Crit Care Med 176: 886–891PubMedCrossRefGoogle Scholar
  5. 5.
    Kleinman SH, Popovsky MA (2008) TRALI: Mechanisms, Management, and Prevention, 1st Ed edn. American Association of Blood Banks Press, BethesdaGoogle Scholar
  6. 6.
    Gresens CJ, Holland PV (2001) Blood Safety and Surveillance. Marcel Dekker Inc, New YorkGoogle Scholar
  7. 7.
    Napolitano LM, Kurek S, Luchette FA (2009) Clinical practice guideline: red blood cell transfusion in adult trauma and critical care. Crit Care Med 37: 3124–3157PubMedCrossRefGoogle Scholar
  8. 8.
    Fatalities Reported to FDA Following Blood Collection and Transfusion: Annual Summary for Fiscal Year 2010. Available at: http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/ ReportaProblem/TransfusionDonationFatalities/ucm254802.htm Accessed November 2011Google Scholar
  9. 9.
    SHOT Steering Group (2010) Serious Hazards of Transfusion Annual Report 2010 Summary Available at: http://www.shotuk.org/wp-content/uploads/2011/07/SHOT-2010-Summary1. pdf Accessed November 2011Google Scholar
  10. 10.
    Popovsky MA, Abel MD, Moore SB (1983) Transfusion-related acute lung injury associated with passive transfer of antileukocyte antibodies. Am Rev Respir Dis 128: 185–189PubMedGoogle Scholar
  11. 11.
    Kleinman S, Caulfield T, Chan P, et al (2004) Toward an understanding of transfusionrelated acute lung injury: statement of a consensus panel. Transfusion 44: 1774–1789PubMedCrossRefGoogle Scholar
  12. 12.
    Kopko PM, Marshall CS, MacKenzie MR, Holland PV, Popovsky MA (2002) Transfusionrelated acute lung injury: report of a clinical look-back investigation. JAMA 287: 1968–1971PubMedCrossRefGoogle Scholar
  13. 13.
    Eder AF, Herron R, Strupp A, et al (2007) Transfusion-related acute lung injury surveillance (2003-2005) and the potential impact of the selective use of plasma from male donors in the American Red Cross. Transfusion 47: 599–607PubMedCrossRefGoogle Scholar
  14. 14.
    Goldman M, Webert KE, Arnold DM, Freedman J, Hannon J, Blajchman MA (2005) Proceedings of a consensus conference: towards an understanding of TRALI. Transfus Med Rev 19: 2–31PubMedCrossRefGoogle Scholar
  15. 15.
    Eder AF, Herron RM, Jr., Strupp A, et al (2010) Effective reduction of transfusion-related acute lung injury risk with male-predominant plasma strategy in the American Red Cross (2006–2008). Transfusion 50: 1732–1742PubMedCrossRefGoogle Scholar
  16. 16.
    Kleinman S, Grossman B, Kopko P (2010) A national survey of transfusion-related acute lung injury risk reduction policies for platelets and plasma in the United States. Transfusion 50: 1312–1321PubMedCrossRefGoogle Scholar
  17. 17.
    Brown CJ, Navarrete CV (2011) Clinical relevance of the HLA system in blood transfusion. Vox Sang 101: 93–105PubMedCrossRefGoogle Scholar
  18. 18.
    Bux J, Sachs UJ (2007) The pathogenesis of transfusion-related acute lung injury (TRALI). Br J Haematol 136: 788–799PubMedCrossRefGoogle Scholar
  19. 19.
    Silliman CC, Moore EE, Kelher MR, Khan SY, Gellar L, Elzi DJ (2011) Identification of lipids that accumulate during the routine storage of prestorage leukoreduced red blood cells and cause acute lung injury. Transfusion 51: 2549–2554PubMedCrossRefGoogle Scholar
  20. 20.
    Kopko PM, Paglieroni TG, Popovsky MA, Muto KN, MacKenzie MR, Holland PV (2003) TRALI: correlation of antigen-antibody and monocyte activation in donor-recipient pairs. Transfusion 43: 177–184PubMedCrossRefGoogle Scholar
  21. 21.
    Silliman CC (2006) The two-event model of transfusion-related acute lung injury. Crit Care Med 34 (5 Suppl): S124–131CrossRefGoogle Scholar
  22. 22.
    Kor DJ, Van Buskirk CM, Gajic O (2009) Red blood cell storage lesion. Bosn J Basic Med Sci 9 (Suppl 1): 21–27PubMedGoogle Scholar
  23. 23.
    Popovsky MA, Moore SB (1985) Diagnostic and pathogenetic considerations in transfusion-related acute lung injury. Transfusion 25: 573–577PubMedCrossRefGoogle Scholar
  24. 24.
    Gajic O, Moore SB (2005) Transfusion-related acute lung injury. Mayo Clin Proc 80: 766–770PubMedGoogle Scholar
  25. 25.
    The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342: 1301–1308CrossRefGoogle Scholar
  26. 26.
    Briel M, Meade M, Mercat A, et al (2010) Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 303: 865–873PubMedCrossRefGoogle Scholar
  27. 27.
    Jawa RS, Anillo S, Kulaylat MN (2008) Transfusion-related acute lung injury. J Intensive Care Med 23: 109–121PubMedCrossRefGoogle Scholar
  28. 28.
    Wiedemann HP, Wheeler AP, Bernard GR, et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354: 2564–2575PubMedCrossRefGoogle Scholar
  29. 29.
    Steinberg KP, Hudson LD, Goodman RB, et al (2006) Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med 354: 1671–1684PubMedCrossRefGoogle Scholar
  30. 30.
    Meduri GU, Headley AS, Golden E, et al (1998) Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA 280: 159–165PubMedCrossRefGoogle Scholar
  31. 31.
    Weigelt JA, Norcross JF, Borman KR, Snyder WH 3rd (1985) Early steroid therapy for respiratory failure. Arch Surg 120: 536–540PubMedCrossRefGoogle Scholar
  32. 32.
    Jacobson JR, Barnard JW, Grigoryev DN, Ma SF, Tuder RM, Garcia JG (2005) Simvastatin attenuates vascular leak and inflammation in murine inflammatory lung injury. Am J Physiol Lung Cell Mol Physiol 288: L1026–1032PubMedCrossRefGoogle Scholar
  33. 33.
    Kor DJ, Iscimen R, Yilmaz M, Brown MJ, Brown DR, Gajic O (2009) Statin administration did not influence the progression of lung injury or associated organ failures in a cohort of patients with acute lung injury. Intensive Care Med 35: 1039–1046PubMedCrossRefGoogle Scholar
  34. 34.
    O’Neal HRJ, Koyama T, Koehler EAS (2011) Prehospital statin and aspirin use and the prevalence of severe sepsis and acute lung injury/acute respiratory distress syndrome. Crit Care Med 39: 1343–1350CrossRefGoogle Scholar
  35. 35.
    Su L, Kamel H (2007) How do we investigate and manage donors associated with a suspected case of transfusion-related acute lung injury. Transfusion 47: 1118–1124PubMedCrossRefGoogle Scholar
  36. 36.
    Hébert PC, Wells G, Blajchman MA (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators. N Engl J Med 340: 409–417PubMedCrossRefGoogle Scholar
  37. 37.
    Wilson K, MacDougall L, Fergusson D, Graham I, Tinmouth A, Hebert PC (2002) The effectiveness of interventions to reduce physician’s levels of inappropriate transfusion: what can be learned from a systematic review of the literature. Transfusion 42: 1224–1229PubMedCrossRefGoogle Scholar
  38. 38.
    Cameron B, Rock G, Olberg B, Neurath D (2007) Evaluation of platelet transfusion triggers in a tertiary-care hospital. Transfusion 47: 206–211PubMedCrossRefGoogle Scholar
  39. 39.
    Blumberg N, Heal JM, Gettings KF, et al (2010) An association between decreased cardiopulmonary complications (transfusion-related acute lung injury and transfusion-associated circulatory overload) and implementation of universal leukoreduction of blood transfusions. Transfusion 50: 2738–2744PubMedCrossRefGoogle Scholar
  40. 40.
    Watkins TR, Rubenfeld GD, Martin TR, et al (2008) Effects of leukoreduced blood on acute lung injury after trauma: a randomized controlled trial. Crit Care Med 36: 1493–1499PubMedCrossRefGoogle Scholar
  41. 41.
    Silliman CC, Clay KL, Thurman GW, Johnson CA, Ambruso DR (1994) Partial characterization of lipids that develop during the routine storage of blood and prime the neutrophil NADPH oxidase. J Lab Clin Med 124: 684–694PubMedGoogle Scholar
  42. 42.
    Koch CG, Li L, Sessler DI et al (2008) Duration of red-cell storage and complications after cardiac surgery. N Engl J Med 358: 1229–1239PubMedCrossRefGoogle Scholar
  43. 43.
    Vamvakas EC, Blajchman MA (2010) Blood still kills: six strategies to further reduce allogenic blood transfusion-related mortality. Transfus Med Rev 24: 77–124PubMedCrossRefGoogle Scholar
  44. 44.
    Silliman CC, Moore EE, Johnson JL, Gonzalez RJ, Biffl WL (2004) Transfusion of the injured patient: proceed with caution. Shock 21: 291–299PubMedCrossRefGoogle Scholar
  45. 45.
    Biffl WL, Moore EE, Offner PJ, Ciesla DJ, Gonzalez RJ, Silliman CC (z) Plasma from aged stored red blood cells delays neutrophil apoptosis and primes for cytotoxicity: abrogation by poststorage washing but not prestorage leukoreduction. J Trauma 50: 426–431Google Scholar
  46. 46.
    Preston FE, Laidlaw ST, Sampson B, Kitchen S (2002) Rapid reversal of oral anticoagulation with warfarin by a prothrombin complex concentrate (Beriplex): efficacy and safety in 42 patients. Br J Haematol 116: 619–624PubMedCrossRefGoogle Scholar
  47. 47.
    Baker RI, Coughlin PB, Gallus AS, Harper PL, Salem HH, Wood EM (2004) Warfarin reversal: consensus guidelines, on behalf of the Australasian Society of Thrombosis and Haemostasis. Med J Aust 181: 492–497PubMedGoogle Scholar
  48. 48.
    Roback JD, Combs MR, Grossman BJ, Hillyer CD (2008) Technical Manual 16th edn. American Association of Blood Banks, BethesdaGoogle Scholar
  49. 49.
    Narick C, Triulzi DJ, Yazer MH (2011) Transfusion-associated circulatory overload after plasma transfusion. Transfusion (in press)Google Scholar
  50. 50.
    Li G, Rachmale S, Kojicic M (2011) Incidence and transfusion risk factors for transfusionassociated circulatory overload among medical intensive care unit patients. Transfusion 51: 338–343PubMedCrossRefGoogle Scholar
  51. 51.
    Audet AM, Andrzejewski C, Popovsky MA (1998) Red blood cell transfusion practices in patients undergoing orthopedic surgery: a multi-institutional analysis. Orthopedics 21: 851–858PubMedGoogle Scholar
  52. 52.
    Rana RM, Rana SM, Fernandez ERM, Khan SAM, Gajic OM (2005) Transfusion related pulmonary edema in the intensive care unit (ICU). Chest 128 (Suppl):130s (abst)Google Scholar
  53. 53.
    Popovsky MA (2010) The Emily Cooley Lecture 2009: To breathe or not to breathe — that is the question. Pulmonary consequences of transfusion. Transfusion 50: 2057–2062CrossRefGoogle Scholar
  54. 54.
    Finlay HE, Cassoria L, Feiner J, Toy P (2005) Designing and testing a computer-based screening system for transfusion-related acute lung injury. Am J Clin Path 124: 601–609PubMedCrossRefGoogle Scholar
  55. 55.
    David B (2002) Haemovigilance: A comparison of three national systems. Proceedings of the 27th Congress of the International Society of Blood Transfusion: August 24-29th 2002, Vancouver (abst)Google Scholar
  56. 56.
    Li GM, Kojicic MM, Reriani MKM, et al (2010) Long-term survival & quality of life after transfusion-associated pulmonary edema in critically ill medical patients. Chest 137: 783–789PubMedCrossRefGoogle Scholar
  57. 57.
    Whitaker BI. Reporting TACO and TRALI: Using the New National Hemovigilance Protocol to Categorize Transfusion Adverse Reactions. Available at: http://www.aabb.org/programs/ biovigilance/us/Documents/reportingtralitaco.pdf Accessed November 2011Google Scholar
  58. 58.
    Center for Disease Control (2010) National Healthcare Safety Network Manual-Biovigilance Component Protocol. In: Transfusion Associated Circulatory Overload. Center for Disease Control, AltantaGoogle Scholar
  59. 59.
    Singel DJ, Stamler JS (2005) Chemical physiology of blood flow regulation by red blood cells: the role of nitric oxide and S-nitrosohemoglobin. Annu Rev Physiol 67: 99–145PubMedCrossRefGoogle Scholar
  60. 60.
    Celis R, Torre-Martinez G, Torre-Amione G (2008) Evidence for activation of immune system in heart failure: is there a role for anti-inflammatory therapy? Curr Opin Cardiol 3: 254–260CrossRefGoogle Scholar
  61. 61.
    Robillard P, Itaj NK, Chapdelaine A (2008) Increasing incidence of transfusion-associated circulatory overload reported to the Quebec Hemovigilance System 2000–2006. Transfusion 48:204A (abst)CrossRefGoogle Scholar
  62. 62.
    Nieminen MS, Bohm M, Cowie MR, et al (2005) Executive summary of the guidelines on the diagnosis and treatment of acute heart failure — The Task Force on Acute Heart Failure of the European Society of Cardiology. Eur Heart J 26: 384–416PubMedCrossRefGoogle Scholar
  63. 63.
    Jessup M, Abraham WT, Casey DE, et al (2009) 2009 Focused Update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation. Circulation 119: 1977–2016PubMedCrossRefGoogle Scholar
  64. 64.
    Winck JC, Azevedo LF, Costa-Pereira A, Antonelli M, Wyatt JC (2006) Efficacy and safety of non-invasive ventilation in the treatment of acute cardiogenic pulmonary edema—a systematic review and meta-analysis. Crit Care 10:R69PubMedCrossRefGoogle Scholar
  65. 65.
    Popovsky MA (2007) Transfusion Reactions, 3rd edn. AABB Press, BethesdaGoogle Scholar
  66. 66.
    Skeate RC, Eastlund T (2007) Distinguishing between transfusion related acute lung injury and transfusion associated circulatory overload. Curr Opin Haematol 14: 682–687CrossRefGoogle Scholar
  67. 67.
    Wheeler AP, Bernard GR, Thompson BT et al (2006) Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. N Engl J Med 354: 2213–2224PubMedCrossRefGoogle Scholar
  68. 68.
    Ely EW, Smith AC, Chiles C, et al (2001) Radiologic determination of intravascular volume status using portable, digital chest radiography: a prospective investigation in 100 patients. Crit Care Med 8: 1502–1512Google Scholar
  69. 69.
    Maisel AS, Krishnaswamy P, Nowak RM et al (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med, 347(3):161–167.PubMedCrossRefGoogle Scholar
  70. 70.
    Zhou I, Giacherio D, Cooling L, Davenport RD (2005) Use of B-natriuretic peptide as a diagnostic marker of the differential diagnosis of transfusion-associated circulatory overload. Transfusion 45: 1056–1063PubMedCrossRefGoogle Scholar
  71. 71.
    Tobain AAR (2008) N-Terminal pro-brain natriuretic peptide is a useful diagnostic marker for transfusion-associated circulatory overload. Transfusion 48: 1143–1150.CrossRefGoogle Scholar
  72. 72.
    Li G, Daniels CE, Kojicic M (2009) The accuracy of naturietic peptides (brain naturietic peptids and N-terminal pro-brain naturietic) in differentiation between transfusionrelated acute lung injury and transfusion-related circulatory overload in the critically ill. Transfusion 49: 13–20PubMedCrossRefGoogle Scholar
  73. 73.
    Rana R, Vlahakis NE, Daniels CE, et al (2006) B-type natriuretic peptide in the assessment of acute lung injury and cardiogenic pulmonary edema. Crit Care Med 34: 1941–1946PubMedCrossRefGoogle Scholar
  74. 74.
    Gilliss BM, Looney MR (2011) Experimental models of transfusion-related acute lung injury. Transfus Med Rev 25: 1–11PubMedCrossRefGoogle Scholar
  75. 75.
    Fadeyi EA, De Los Angeles Muniz M, Wayne AS, Klein HG, Leitman SF, Stroncek DF (2007) The transfusion of neutrophil-specific antibodies causes leukopenia and a broad spectrum of pulmonary reactions. Transfusion 47: 545–550PubMedCrossRefGoogle Scholar
  76. 76.
    Church GD, Price C, Sanchez R, Looney MR (2006) Transfusion-related acute lung injury in the paediatric patient: Two case reports and a review of the literature. Transfus Med 16: 343–348PubMedCrossRefGoogle Scholar
  77. 77.
    Fein A, Grossman RF, Jones JG, et al (1979) The value of edema fluid protein measurement in patients with pulmonary edema. Am J Med 67: 32–38PubMedCrossRefGoogle Scholar
  78. 78.
    Gajic O, Gropper MA, Hubmayr RD (2006) Pulmonary edema after transfusion: How to differentiate transfusion-associated circulatory overload from transfusion-related acute lung injury. Crit Care Med 34 (Suppl 5): s109–s113PubMedCrossRefGoogle Scholar
  79. 79.
    Payne R (1962) The development and persistence of leukoagglutinins in parous women. Blood 19: 411–424PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • A. D. Goldberg
  • L. Clifford
  • D. J. Kor

There are no affiliations available

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