ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS.
Background. We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). Methods. We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or m...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2014-10-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | http://www.mjhid.org/index.php/mjhid/article/view/2043 |
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| author | Luciana Teofili Maria Bianchi Bruno A Zanfini Stefano Catarci Rossella Sicuranza Serena Spartano Gina Zini Gaetano Draisci |
| author_facet | Luciana Teofili Maria Bianchi Bruno A Zanfini Stefano Catarci Rossella Sicuranza Serena Spartano Gina Zini Gaetano Draisci |
| author_sort | Luciana Teofili |
| collection | DOAJ |
| description | Background. We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH).
Methods. We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without fresh frozen plasma (FFP) and platelet (PLT) transfusion. Clinical records were then retrieved and examined for respiratory distress events. According to the 2004 consensus definition, cases of new-onset hypoxemia within 6 hours after transfusion, with bilateral pulmonary changes in the absence of cardiogenic pulmonary edema were identified as TRALI; if an alternative risk factor for acute lung injury was present, possible TRALI was diagnosed.
Results. Thirteen cases of TRALI and 1 case of possible TRALI were identified (overall incidence 19.7%). At univariate analysis, patients with TRALI received higher number of RBC, PLT and FFP units and had a longer post-partum hospitalization. Among several pregnancy-related diseases (including hypertensive disorders, anemia, intrahepatic cholestasis, gestational diabetes) and various pre-existing comorbidities, only gestational hypertension and pre-eclampsia significantly increased the risk to develop TRALI (p = 0.006). At multivariate analysis, including both transfusion- and patient-related risk factors, pregnancy-related hypertensive disorders were confirmed to be the only predictors for TRALI, with an odds ratio of 27.7 ( 95% CI 1.27-604.3, p=0.034).
Conclusions. Patients suffering from PPH represent a high-risk population for TRALI. In particular, patients with gestational hypertension and pre-eclampsia have the highest risk, particularly if they are not receiving anti-hypertensive therapy. A careful monitoring of these patients after transfusions is therefore recommended. |
| format | Article |
| id | doaj-art-f96eefe0c7704c548d9a33a62bfd1596 |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2014-10-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-f96eefe0c7704c548d9a33a62bfd15962025-01-02T01:51:36ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062014-10-0161e2014069e201406910.4084/mjhid.2014.0691499ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS.Luciana TeofiliMaria BianchiBruno A ZanfiniStefano CatarciRossella SicuranzaSerena SpartanoGina ZiniGaetano DraisciBackground. We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). Methods. We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without fresh frozen plasma (FFP) and platelet (PLT) transfusion. Clinical records were then retrieved and examined for respiratory distress events. According to the 2004 consensus definition, cases of new-onset hypoxemia within 6 hours after transfusion, with bilateral pulmonary changes in the absence of cardiogenic pulmonary edema were identified as TRALI; if an alternative risk factor for acute lung injury was present, possible TRALI was diagnosed. Results. Thirteen cases of TRALI and 1 case of possible TRALI were identified (overall incidence 19.7%). At univariate analysis, patients with TRALI received higher number of RBC, PLT and FFP units and had a longer post-partum hospitalization. Among several pregnancy-related diseases (including hypertensive disorders, anemia, intrahepatic cholestasis, gestational diabetes) and various pre-existing comorbidities, only gestational hypertension and pre-eclampsia significantly increased the risk to develop TRALI (p = 0.006). At multivariate analysis, including both transfusion- and patient-related risk factors, pregnancy-related hypertensive disorders were confirmed to be the only predictors for TRALI, with an odds ratio of 27.7 ( 95% CI 1.27-604.3, p=0.034). Conclusions. Patients suffering from PPH represent a high-risk population for TRALI. In particular, patients with gestational hypertension and pre-eclampsia have the highest risk, particularly if they are not receiving anti-hypertensive therapy. A careful monitoring of these patients after transfusions is therefore recommended.http://www.mjhid.org/index.php/mjhid/article/view/2043Anemia, TRALI |
| spellingShingle | Luciana Teofili Maria Bianchi Bruno A Zanfini Stefano Catarci Rossella Sicuranza Serena Spartano Gina Zini Gaetano Draisci ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS. Mediterranean Journal of Hematology and Infectious Diseases Anemia, TRALI |
| title | ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS. |
| title_full | ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS. |
| title_fullStr | ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS. |
| title_full_unstemmed | ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS. |
| title_short | ACUTE LUNG INJURY COMPLICATING BLOOD TRANSFUSION IN POST-PARTUM HEMORRHAGE: INCIDENCE AND RISK FACTORS. |
| title_sort | acute lung injury complicating blood transfusion in post partum hemorrhage incidence and risk factors |
| topic | Anemia, TRALI |
| url | http://www.mjhid.org/index.php/mjhid/article/view/2043 |
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