Author/Editor     Galvani, Vesna; Maver, Slavica; Soldatović, Gordana; Kramar, Irena
Title     Prvi primer s transfuzijo povezane akutne poškodbe pljuč (TRALI) v Sloveniji
Translated title     First report of transfusion-related acute lung injury (TRALI) in Slovenia
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 77, št. 4
Publication year     2008
Volume     str. 323-9
Language     slo
Abstract     Background Transfusion-related acute lung injury (TRALI) is a major cause of lethal side effects associated with transfusion of blood and blood components. TRALI is defined as a new acute noncardiogenic pulmonary oedema as seen on the frontal radiography of lungs, manifested with the shortness of breath, hypoxemia, hypotension and fever, all occurring during or within 6h after transfusion. TRALI is rarely diagnosed and can be confused with other causes of acute respiratory failure. It occurs at the ratio of 1 in 1,120 to 1 in 5,000 transfusions of blood or blood components. The fatal incidence is 5% to 25% according to USA statistics. The data for Slovenia are not available as this is the first case reported ever. Case This article analyses a case of a female patient who had a hip replacement surgery, was transfused with erythrocyte components, which was followed by TRALI. Radiographs and laboratooy analysis are presented. Conclusions The recognition of symptoms of TRALI on the part of clinicians could be crucial in preventing and treating this severe complication of blood transfusion.
Summary     Izhodišča S transfuzijo povezana akutna poškodba pljuč (TRALI) je glavni vzrok zapletov s smrtnim izidom, povezanih s transfuzijo krvi ali krvnih pripravkoov. TRALI je nova akutna poškodba pljuč. ki se pojavi v prvih 6 urah po opravljeni trunsfuziji in se pojavi skupaj z zasoplostjo, hipoksemijo, hipotenzijo, vročino ter obojestranskimi infiltracijami, vidnimi na frontalnem radiološkem posnetku pljuč ob odsotvnsti preobremenitve obtoka. Po podatkih iz ZDA je ocenjena incidenca TRALI od 1:1120 do 1:5000 transfundiranih enot krvi ali krvnih komponent. Umrljivost je po poročilih različnih avtorjev pri TRALI od 5% clo 25%. Podatkov za Slovenijo ni, saj je objavljeni primer prvi. Vzrok je najbrž potrebno iskati v nedoslednem poročanju ustrezni transfuziološki ustanovi in mogoče pomanjkljivemu prepoznavanju simptomov. Bolnik Članek obravnava primer bolnice, ki je po operaciji zaradi zamenjave kolčne proteze dobila transfuzijo koncentriranih eritrocitov, po kateri je natstppila TRALI. Prikazane so radiološke slike bolnice pred in med TRALI ter spremljani laboratorijski parametri, povezani s potrjevanjem zapleta. Zaključki Potek TRALI je izjemno hiter, zato je ključnega pomena, da ob hudi dihalni stiski po transfuziji pomislimo na TRALI ter pravočasno in pravilno ukrepamo.
Descriptors     BLOOD TRANSFUSION
PULMONARY EDEMA
LEUKOPENIA
HIP PROSTHESIS
ERYTHROCYTE TRANSFUSION
ADULT
FATAL OUTCOME