Tags

Type your tag names separated by a space and hit enter

Transfusion-related acute lung injury in the critically ill: prospective nested case-control study.
Am J Respir Crit Care Med. 2007 Nov 01; 176(9):886-91.AJ

Abstract

RATIONALE

Acute lung injury (ALI) that develops 6 hours after transfusion (TRALI) is the leading cause of transfusion-related mortality. Several transfusion characteristics have been postulated as risk factors for TRALI, but the evidence is limited to retrospective studies.

OBJECTIVES

To compare patient and transfusion risk factors between patients who do and do not develop ALI.

METHODS

In this prospective cohort study, consecutive transfused critically ill patients were closely observed for development of ALI. Donor samples were collected from the transfusion bags. Risk factors were compared between patients who developed ALI after transfusion and transfused control patients, matched by age, sex, and admission diagnosis.

MEASUREMENTS AND MAIN RESULTS

Seventy-four of 901 transfused patients developed ALI within 6 hours of transfusion (8%). Compared with transfused control subjects, patients with ALI were more likely to have sepsis (37 vs. 22%, P = 0.016) and a history of chronic alcohol abuse (37 vs. 18%, P = 0.006). When adjusted for patient characteristics, transfusion of plasma from female donors (odds ratio [OR], 5.09; 95% confidence interval [95% CI], 1.37-18.85) rather than male donors (OR, 1.60; 95% CI, 0.76 to 3.37), number of pregnancies among the donors (OR, 1.19; 95% CI, 1.05 to 1.34), number of donor units positive for anti-granulocyte antibodies (OR, 4.85; 95% CI, 1.32-17.86) and anti-HLA class II antibodies (OR, 3.08; 95% CI, 1.15-8.25), and concentration of lysophosphatidylcholine in the donor product (OR, 1.69; 95% CI, 1.10 to 2.59) were associated with the development of ALI.

CONCLUSIONS

Both patient and transfusion risk factors determine the probability of ALI after transfusion. Transfusion factors represent attractive targets for the prevention of ALI.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. gajic.ognjen@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17626910

Citation

Gajic, Ognjen, et al. "Transfusion-related Acute Lung Injury in the Critically Ill: Prospective Nested Case-control Study." American Journal of Respiratory and Critical Care Medicine, vol. 176, no. 9, 2007, pp. 886-91.
Gajic O, Rana R, Winters JL, et al. Transfusion-related acute lung injury in the critically ill: prospective nested case-control study. Am J Respir Crit Care Med. 2007;176(9):886-91.
Gajic, O., Rana, R., Winters, J. L., Yilmaz, M., Mendez, J. L., Rickman, O. B., O'Byrne, M. M., Evenson, L. K., Malinchoc, M., DeGoey, S. R., Afessa, B., Hubmayr, R. D., & Moore, S. B. (2007). Transfusion-related acute lung injury in the critically ill: prospective nested case-control study. American Journal of Respiratory and Critical Care Medicine, 176(9), 886-91.
Gajic O, et al. Transfusion-related Acute Lung Injury in the Critically Ill: Prospective Nested Case-control Study. Am J Respir Crit Care Med. 2007 Nov 1;176(9):886-91. PubMed PMID: 17626910.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transfusion-related acute lung injury in the critically ill: prospective nested case-control study. AU - Gajic,Ognjen, AU - Rana,Rimki, AU - Winters,Jeffrey L, AU - Yilmaz,Murat, AU - Mendez,Jose L, AU - Rickman,Otis B, AU - O'Byrne,Megan M, AU - Evenson,Laura K, AU - Malinchoc,Michael, AU - DeGoey,Steven R, AU - Afessa,Bekele, AU - Hubmayr,Rolf D, AU - Moore,S Breanndan, Y1 - 2007/07/12/ PY - 2007/7/14/pubmed PY - 2007/12/14/medline PY - 2007/7/14/entrez SP - 886 EP - 91 JF - American journal of respiratory and critical care medicine JO - Am J Respir Crit Care Med VL - 176 IS - 9 N2 - RATIONALE: Acute lung injury (ALI) that develops 6 hours after transfusion (TRALI) is the leading cause of transfusion-related mortality. Several transfusion characteristics have been postulated as risk factors for TRALI, but the evidence is limited to retrospective studies. OBJECTIVES: To compare patient and transfusion risk factors between patients who do and do not develop ALI. METHODS: In this prospective cohort study, consecutive transfused critically ill patients were closely observed for development of ALI. Donor samples were collected from the transfusion bags. Risk factors were compared between patients who developed ALI after transfusion and transfused control patients, matched by age, sex, and admission diagnosis. MEASUREMENTS AND MAIN RESULTS: Seventy-four of 901 transfused patients developed ALI within 6 hours of transfusion (8%). Compared with transfused control subjects, patients with ALI were more likely to have sepsis (37 vs. 22%, P = 0.016) and a history of chronic alcohol abuse (37 vs. 18%, P = 0.006). When adjusted for patient characteristics, transfusion of plasma from female donors (odds ratio [OR], 5.09; 95% confidence interval [95% CI], 1.37-18.85) rather than male donors (OR, 1.60; 95% CI, 0.76 to 3.37), number of pregnancies among the donors (OR, 1.19; 95% CI, 1.05 to 1.34), number of donor units positive for anti-granulocyte antibodies (OR, 4.85; 95% CI, 1.32-17.86) and anti-HLA class II antibodies (OR, 3.08; 95% CI, 1.15-8.25), and concentration of lysophosphatidylcholine in the donor product (OR, 1.69; 95% CI, 1.10 to 2.59) were associated with the development of ALI. CONCLUSIONS: Both patient and transfusion risk factors determine the probability of ALI after transfusion. Transfusion factors represent attractive targets for the prevention of ALI. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/17626910/full_citation L2 - https://www.atsjournals.org/doi/10.1164/rccm.200702-271OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -