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
- Sepsis
RESULTS: The relative plasma miR-155 and miR-146a concentrations were significantly increased in severe sepsis and sepsis-induced cases of ALI, compared with control subjects. [ncbi.nlm.nih.gov]
- Hypoxemia
The refractory hypoxemia was improved by high-frequency oscillatory ventilation. [ncbi.nlm.nih.gov]
- Hunting
Bersten AD, Edibam C, Hunt T, Moran J; Australian and New Zealand Intensive Care Society Clinical Trials Group. Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian States. [scielo.br]
Bersten AD, Edibam C, Hunt T, Moran J. Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian states. Am J Respir Crit Care Med 2002 ;165: 443 - 448 14. [nejm.org]
N Engl J Med 353 : 1685 – 1693, 2005 ↵ Bersten AD, Edibam C, Hunt T, Moran J: Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian States. [cjasn.asnjournals.org]
View Article PubMed Google Scholar Stewart RM, Park PK, Hunt JP, McIntyre RC, McCarthy J, Zarzabal LA, Michalek JE, National Institutes of Health/National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Clinical Trials Network: Less [sjtrem.biomedcentral.com]
- Congestive Heart Failure
TRALI is often mistaken for other transfusion reactions, most notably pulmonary edema caused by circulatory overload or congestive heart failure. It is difficult to gauge which transfusion recipients are at risk for TRALI. [ncbi.nlm.nih.gov]
Clinical examination reveals hypoxic respiratory distress, and pulmonary crackles may be present without signs of congestive heart failure or volume overload. [professionaleducation.blood.ca]
Patients with diagnoses of acute myocardial infarction or congestive heart failure on admission to the ICU and with no identifiable risk factors for acute lung injury were considered to have clinical evidence of left atrial hypertension, as were patients [nejm.org]
- Surgical Procedure
The surgical procedure involves dissection, major vessel manipulation, and pathophysiologic effects of graft storage and reperfusion. As a result, LT frequently involves significant hemorrhage. [ncbi.nlm.nih.gov]
Since no surgical procedures using extracorporeal circulation are performed in this department of emergency medicine, this risk factor was not added. [scielo.br]
One-lung ventilation is required in most thoracic surgical procedures, such as lung resection, aortic surgery, cardiac surgery and esophageal resection. [omicsonline.org]
Results A total of 83,204 unique patients underwent surgical procedures at our institution during the index calendar years (41,490 in 2004 and 41,714 in 2011). [anesthesiology.pubs.asahq.org]
Respiratoric
- Pneumonia
In addition, a few cases of interstitial pneumonia associated with their use have been reported in the Japanese literature. [ncbi.nlm.nih.gov]
Alveolar epithelial cells orchestrate DC function in murine viral pneumonia. J Clin Inv 2012; 122:3652-64. [dzl.de]
- 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]
Cardiovascular
- Mitral Valve Prolapse
Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med 1999 ;341: 1 - 7 34. Griffin MR, Wilson WR, Edwards WD, O'Fallon WM, Kurland LT. Infective endocarditis: Olmsted County, Minnesota, 1950 through 1981. [nejm.org]
Eyes
- Prolapse
Prevalence and clinical outcome of mitral-valve prolapse. N Engl J Med 1999 ;341: 1 - 7 34. Griffin MR, Wilson WR, Edwards WD, O'Fallon WM, Kurland LT. Infective endocarditis: Olmsted County, Minnesota, 1950 through 1981. [nejm.org]
Psychiatrical
- Suggestibility
The second hypothesis suggests that neutrophils accumulate and are primed in the patient's pulmonary microvasculature as a result of preexisting systemic inflammation. [en.wikipedia.org]
Furthermore, administration of granulocyte-colony stimulating factor was suggested to predispose the patient to TRALI by priming the neutrophils. [ncbi.nlm.nih.gov]
Neurologic
- Irritability
The following day she reported progressive pain in lower abdomen with signs of peritoneal irritation. Emergency laparotomy was performed and active bleeding from fallopian tube was stopped. [ncbi.nlm.nih.gov]
[…] response modifiers” (BRMs) such as cytokines and biologically active lipids (e.g. in aged cellular components) cause a lung-mediated response Pathophysiology “2 hit” model: lung capillaries are primed by an underlying illness then triggered by exposure to irritant [lifeinthefastlane.com]
[…] damage Cardiac: abnormal heart rhythms, myocardial dysfunction Kidney: acute kidney failure, positive fluid balance Mechanical: vascular injury, pneumothorax (by placing pulmonary artery catheter), tracheal injury/stenosis (result of intubation and/or irritation [en.wikipedia.org]
- Excitement
Speaking about the development, Professor Chris Scott from the School of Pharmacy, who is leading the research, said: "Nanoparticles are perhaps one of the most exciting new approaches to drug development. [sciencedaily.com]
This additional support led to the approval of an IND for the Phase 1 trial of this exciting new therapy, which enrolled its first patient here at UCSF in early July of this year. [ucsf.edu]
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]
- Bilateral Pulmonary Infiltrates
In our cases, both patients presented with dyspnea and hypoxemia during transfusion of packed red blood cells and showed findings of bilateral pulmonary infiltrations at chest radiography. [ncbi.nlm.nih.gov]
The radiological picture is of bilateral pulmonary infiltrates without evidence of cardiac compromise or fluid overload. Symptoms typically begin 1-2 hours after transfusion and are fully manifest within 1-6 hours. [fda.gov]
pulmonary infiltrates not cardiogenic in origin (PAWP < 18mmHg) DIFFERENTIAL DIAGNOSIS acute pulmonary oedema e.g. [lifeinthefastlane.com]
- X-Ray Abnormal
Early on, it was recognized that ALI and ARDS represented a clinical spectrum, which included a continuum of P/F ratio and X-ray abnormalities, and that arbitrary cutoff values would have to be established. [journals.lww.com]
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]