Transfusion Related Acute Lung Injury or TRALI is a syndrome that occurs in approximately 1 in 5000 transfusions. It is thought to be due to donor antibodies to leukocytes which react with the patient's WBC's in the pulmonary microvasculature. This may occur after any type of transfusion but is most common after plasma-containing products.
Symptoms occur within 6 hours of transfusion and range from mild dyspnea to non-cardiogenic pulmonary edema to an ARDS-like picture. The patients have a sudden onset of hypoxia and may be hypotensive or febrile.
Diagnosis is made based on the clinical presentation and a chest xray that shows diffuse patchy pulmonary edema.
Treatment is supportive care with aggressive respiratory support. The syndrome will resolve within 48-96 hours.
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