Transfusionsassoziierte akute Lungeninsuffizienz
Standard
Transfusionsassoziierte akute Lungeninsuffizienz. / Tank, S; Sputtek, A; Kiefmann, R.
in: ANAESTHESIST, Jahrgang 62, Nr. 4, 01.04.2013, S. 254-60.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Transfusionsassoziierte akute Lungeninsuffizienz
AU - Tank, S
AU - Sputtek, A
AU - Kiefmann, R
PY - 2013/4/1
Y1 - 2013/4/1
N2 - Transfusion-related acute lung injury (TRALI) developed into the leading cause of transfusion-related morbidity and mortality after the first description by Popovsky et al. approximately three decades ago. It was the most frequent reason for transfusion-related fatalities worldwide before implementation of risk minimization strategies by donor selection. Plasma-rich blood products, such as fresh frozen plasma and apheresis platelets seem to be the leading triggers of TRALI. Hypoxemia and development of pulmonary edema within 6 h of transfusion are the diagnostic criteria for TRALI. The differentiation between cardiac failure and other transfusion-related lung injuries, such astransfusion-associated circulatory overload ( TACO) is difficult and causal treatment is not available. Therapy is based on supportive measures, such as oxygen insufflationor mechanical ventilation. The exactly pathogenesis is still unknown but the most propagated hypothesis is the two-event-model. Neutrophils are primed by the underlying condition, e.g. sepsis or trauma during the first event and these primed neutrophils are activated by transfused leukoagglutinating antibodies (immunogen) or bioreactive mediators (non-immunogen) during the second-event. Transfusion of leukoagglutinating antibodies from female donors with one or more previous pregnancies is the most frequent reason. No more TRALI fatalities were reported after implementation of the donor selection in Germany in 2009.
AB - Transfusion-related acute lung injury (TRALI) developed into the leading cause of transfusion-related morbidity and mortality after the first description by Popovsky et al. approximately three decades ago. It was the most frequent reason for transfusion-related fatalities worldwide before implementation of risk minimization strategies by donor selection. Plasma-rich blood products, such as fresh frozen plasma and apheresis platelets seem to be the leading triggers of TRALI. Hypoxemia and development of pulmonary edema within 6 h of transfusion are the diagnostic criteria for TRALI. The differentiation between cardiac failure and other transfusion-related lung injuries, such astransfusion-associated circulatory overload ( TACO) is difficult and causal treatment is not available. Therapy is based on supportive measures, such as oxygen insufflationor mechanical ventilation. The exactly pathogenesis is still unknown but the most propagated hypothesis is the two-event-model. Neutrophils are primed by the underlying condition, e.g. sepsis or trauma during the first event and these primed neutrophils are activated by transfused leukoagglutinating antibodies (immunogen) or bioreactive mediators (non-immunogen) during the second-event. Transfusion of leukoagglutinating antibodies from female donors with one or more previous pregnancies is the most frequent reason. No more TRALI fatalities were reported after implementation of the donor selection in Germany in 2009.
KW - Acute Lung Injury
KW - Adult
KW - Blood Donors
KW - Blood Safety
KW - Blood Transfusion
KW - Diagnosis, Differential
KW - Female
KW - Germany
KW - Heart Failure
KW - Humans
KW - Incidence
KW - Oxygen Inhalation Therapy
KW - Plasma
KW - Platelet Transfusion
KW - Pregnancy
KW - Prognosis
KW - Respiration, Artificial
KW - Risk Factors
KW - Risk Reduction Behavior
U2 - 10.1007/s00101-013-2163-0
DO - 10.1007/s00101-013-2163-0
M3 - SCORING: Zeitschriftenaufsatz
C2 - 23558721
VL - 62
SP - 254
EP - 260
JO - ANAESTHESIST
JF - ANAESTHESIST
SN - 0003-2417
IS - 4
ER -