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2.1
Acute Lung Injury

Images

WIKIDATA, CC BY-SA 3.0

Presentation

This presentation is not the classic description of TRALI. Our patient improved with supportive treatment and was successfully extubated on postoperative day 4. [ncbi.nlm.nih.gov]

Entire Body System

  • Hypoxemia

    The refractory hypoxemia was improved by high-frequency oscillatory ventilation. [ncbi.nlm.nih.gov]

  • Anemia

    A 67-year-old man with severe aplastic anemia developed TRALI, consisting of acute respiratory insufficiency with severe hypoxia and diffuse pulmonary infiltration 2 hours after the transfusion of platelet concentrates. [ncbi.nlm.nih.gov]

    They can also look for signs of infection or anemia. Heart tests : These might be ordered to rule out things such as heart failure (when your heart doesn’t pump blood to your body properly). [webmd.com]

  • Weight Loss

    It was found that body weight loss, lung tissue microstructure lesions, transvascular leakage increase, malondialdehyde augmentation, and the reduction of superoxide dismutase and glutathione peroxidase levels caused by LPS challenge were all consistently [ncbi.nlm.nih.gov]

Respiratoric

  • Aspiration

    Herewith we review the advantages and limitations of the use of experimental models of RDS and meconium aspiration syndrome (MAS) and their value for clinics. [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]

    Here, we examined potential benefits of glutamine (GLN) on a two-hit model for VILI after acid aspiration-induced lung injury in rats. [mdpi.com]

    Those with the highest rates (20%-40%) are pneumonia, sepsis and aspiration of gastric content. (6-7,11-12) In the present study, the highest rates of lung injury occurred in patients presenting pulmonary contusion (67%), aspiration of gastric content [scielo.br]

    The data from these prospective and other studies 6 identify sepsis as the most common risk factor for developing ARDS, followed by aspiration pneumonia, pneumonia, trauma, and multiple transfusions. [thorax.bmj.com]

    TACO (transfusion associated circulatory overload), LVF, negative pressure pulmonary edema, neurogenic aspiration pneumonitis inhalational injury ALI/ ARDS due to sepsis or other causes fat embolism diffuse alveolar haemorrhage (expect hemoptysis) INVESTIGATIONS [lifeinthefastlane.com]

  • Cough

    Acute onset of dyspnea, fever, hypotension, and cough during or soon after a blood or blood-product transfusion has been described in the literature since the early 1950s. [ncbi.nlm.nih.gov]

    Chest pain Cough Excessive carbon dioxide in the blood Fatigue Fever Fluid buildup in lungs Low concentration of oxygen in the blood How is Pediatric Acute Lung Injury diagnosed? The following are tests that are used to diagnose acute lung injury. [childrens.com]

    (Pa O 2 :F IO 2 >150 mm Hg) and the abort value ( Criteria for a spontaneous breathing test were a successful PEEP weaning test and presence of the following: no infusion of vasopressor agents or sedatives, adequate responses to simple commands, and cough [jamanetwork.com]

    Maneuvers to increase the respiratory function, including early mobilization, stimulation of an active cough, inspiratory exercises can also be a valid easily provides either an adequate lung expansion or a valid airways toilette [ 59 ]. [omicsonline.org]

Cardiovascular

  • Hypertension

    To identify biomarkers of the pathophysiological changes associated with the syndrome (i.e., alveolocapillary hyperpermeability, DAD, pulmonary hypertension, fibrosis) based on miRNAs sequencing. [ciberes.org]

    During a scheduled infusion, the patient developed hypertension and dyspnea, requiring increasing oxygen supplementation and subsequent intubation. [ncbi.nlm.nih.gov]

    No clinical evidence of left atrial hypertension or if measured, a pulmonary arterial occlusion pressure (PAOP) less than or equal to 18 mmHg 2.4. [isrctn.com]

    Although hypotension is considered one of the important signs in diagnosing TRALI, hypertension can occur in some cases. The cause of TRALI is currently not fully understood. TRALI is thought to be immune mediated. [en.wikipedia.org]

    Five hundred seventy-four of these 1687 patients (34 percent) had left atrial hypertension according to the clinical diagnosis or (when available) data from echocardiography or measurement of pulmonary-artery wedge pressure. [nejm.org]

  • Cyanosis

    We describe a case of 10-year-old male child with aplastic anemia, platelet count of 7800/l, B positive blood group who developed fever (39.2C), difficulty in breathing and cyanosis within 2 hrs after transfusion of a random platelet concentrate. [ncbi.nlm.nih.gov]

    Signs : cyanosis (reflecting hypoxia refractory to oxygen therapy), tachypnoea, tachycardia, peripheral vasodilatation, bilateral fine inspiratory crackles. Investigations FBC, U&E, LFTs, amylase, clotting, CRP, blood cultures, ABG. [patient.info]

    There may be associated fever, cyanosis, and hypotension. Clinical examination reveals hypoxic respiratory distress, and pulmonary crackles may be present without signs of congestive heart failure or volume overload. [professionaleducation.blood.ca]

    The most prominent clinical features described were severe dyspnea, tachypnea, cyanosis refractory to oxygen supplementation, decreased lung compliance, and diffuse chest X-ray infiltrates. [journals.lww.com]

Musculoskeletal

  • Contusion

    Pulmonary contusion As previously mentioned, pulmonary contusion is an independent risk factor for the development of ARDS after trauma [ 35 ] and as such much attention has been paid to quantification of the degree of pulmonary contusion and its ability [sjtrem.biomedcentral.com]

    However, the percentage of patients with multiple trauma who developed lung injury was much lower than that of those presenting pulmonary contusion, aspiration or sepsis ( Table 2 ). [scielo.br]

    By describing whether patients had an acute course with rapid resolution or a more chronic course, the definition differentiated between the rapidly resolving course typical of ARDS secondary to drug overdoses or pulmonary contusion and the complicated [thorax.bmj.com]

    […] fluid embolus Drugs - paraquat, heroin, aspirin Acute pancreatitis Disseminated intravascular coagulation (DIC) Head injury/raised intracranial pressure (ICP) Fat emboli Transfusions of blood products Heart/lung bypass Tumour lysis syndrome Pulmonary contusion [patient.info]

    Table 2: Risk factors for acute lung injury Direct Lung Injury Indirect Lung Injury Aspiration Pneumonia Toxic inhalation Lung contusion Near drowning Severe sepsis Shock Multiple trauma Burn injury Acute pancreatitis Cardiopulmonary bypass Drug overdose [professionaleducation.blood.ca]

Workup

She was managed as TRALI after diagnostic workup and transported to the intensive care unit. In the following days her clinical status changed dramatically with complete recovery. [ncbi.nlm.nih.gov]

X-Ray

  • Pulmonary Infiltrate

    The case of a 33-year-old man with aplastic anemia who experienced recurrent episodes of hypoxemia and pulmonary infiltrates during infusions of antithymocyte globulin (ATG) is described. [ncbi.nlm.nih.gov]

  • Air Bronchogram

    CXR shows bilateral alveolar shadowing, often with air bronchograms. Other investigations as deemed by the clinical scenario - eg, echocardiography. [patient.info]

    […] effusion may be present 10-15% patients have pneumothoraces independent of ventilator settings Computer tomography of the chest can show the heterogeneous nature of ALI, with dependent areas of the lung showing patchy consolidation with air bronchograms [bjmp.org]

Treatment

In vitro, MH-S cells were infected with H9N2 influenza virus with or without kaempferol treatment. [ncbi.nlm.nih.gov]

Prognosis

Treatment and prognosis It tends to be self-limiting and treatment is supportive, with a prognosis substantially better than most causes of clinical acute lung injury. transfusion-associated circulatory overload (TACO) Promoted articles (advertising) [radiopaedia.org]

Abstract Patients with aortic dissection (AD) may present acute lung injury (ALI) that may affect the prognosis. In this study, we aim to investigate the roles and mechanism of IL-22 in the pathogenesis of AD complicated with ALI. [ncbi.nlm.nih.gov]

Etiology

CONCLUSIONS: In the absence of any other known etiology, multiple defibrillation shocks may have played a role in the genesis of ALI in our patient, but this remains speculative. [ncbi.nlm.nih.gov]

Etiology and outcomes of pulmonary and extrapulmonary acute lung injury/ARDS in a respiratory ICU in North India. Chest 2006;130:724-9. [ PUBMED ] [ FULLTEXT ] 12. Hudson LD, Milberg JA, Anardi D, Maunder RJ. [dx.doi.org]

The etiology of TRALI may be attributable to the presence of anti-HLA and/ or anti-granulocyte antibodies in the plasma of multiparous females or donors who have received previous transfusions. [fda.gov]

Epidemiology

Since reliable data on its epidemiology in Brazil are not available, the difficulty to diagnose, varied clinical presentation, and absence of specific laboratory data, case reports are important. [ncbi.nlm.nih.gov]

If there is no prognostic or epidemiological difference between ALI and ARDS patients, then the two categories should be combined. [thorax.bmj.com]

However, these frequencies are higher than those found in national epidemiological studies conducted in the cities of Porto Alegre and São Paulo. (18-19) Comparison with other epidemiological studies is difficult due to methodological differences and, [scielo.br]

Additionally, most studies investigating the epidemiology of TRALI have focused on patients in the critical care setting. [anesthesiology.pubs.asahq.org]

Pathophysiology

The history, pathophysiology, and treatment of TRALI are discussed. Potential preventive measures are reviewed. [ncbi.nlm.nih.gov]

In the present review, we will describe the pathophysiological aspects of acute lung injury induced by combined burn and smoke inhalation and examine various therapeutic approaches. acute lung injury burn and smoke inhalation cytokine nitric oxide (NO [clinsci.org]

Prevention

Prevention of TRALI represents a complex challenge. There is no single intervention that will prevent every case of TRALI, but several interventions have been proposed to reduce the risk. [ncbi.nlm.nih.gov]

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