Chronicle of Hypoxemia: Transfusion-Associated Circulatory Overload Versus Transfusion-Related Acute Lung Injury

被引:3
|
作者
Jha, Shikha [1 ,2 ]
Patel, Keval V. [3 ,4 ]
Bukhari, Amar [5 ]
机构
[1] St Peters Univ Hosp, Internal Med, New Brunswick, NJ 08901 USA
[2] Rutgers State Univ, Robert Wood Johnson Med Sch, Internal Med, New Brunswick, NJ 08854 USA
[3] Robert Wood Johnson Univ Hosp, Cardiol, New Brunswick, NJ USA
[4] St Peters Univ Hosp, Cardiol, New Brunswick, NJ USA
[5] St Peters Univ Hosp, Pulm Crit Care, New Brunswick, NJ USA
关键词
hypoxemia; trali; taco; transfusion associated circulatory overload; transfusion related acute lung injury; REQUIREMENTS;
D O I
10.7759/cureus.28712
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The preeminent causes of blood transfusion-related morbidity and mortality are transfusion-associated circulatory overload (TACO) and transfusion-related acute lung injury (TRALI).These occur within hours of blood transfusion and lead to acute respiratory distress. The differentiation between TACO and TRALI has always been a great challenge in the context of underlying etiology, whether it is volume overloador lung injury, or both.This is a case report of a 64-year-old female with multiple comorbidities, who was brought to the emergency department with generalized weakness. She was hemodynamically unstable and encephalopathic. Her hemoglobin was 6.5 gm/dl with no active evidence of bleeding. She was started on a norepinephrine drip and one unit of packed red blood cells was transfused. A few hours post-transfusion, she became extremely tachypneic and hypoxic.A chest x-ray post-transfusion showed diffuse bilateral fluffy alveolar infiltrates and the N-terminal (NT)-pro hormone Brain Natriuretic Peptide (NT-proBNP) was significantly elevated. The transfusion reaction workup was negative. Due to worsening hypoxia, she required a rapid transition from non-invasive to invasive mechanical ventilation. The chronology of this case report depicts a unique presentation of acute respiratory distress and the course of hypoxemia.
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页数:11
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