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Incidence of transfusion‐related acute lung injury temporally associated with solvent/detergent plasma use in the ICU: A retrospective before and after implementation study

输血相关性急性肺损伤 医学 回顾性队列研究 入射(几何) 急诊医学 重症监护医学 输血 麻醉 内科学 物理 光学 肺水肿
作者
Robert B. Klanderman,Niels van Mourik,Dorus Eggermont,Anna‐Linda Peters,Pieter R. Tuinman,Rob J. Bosman,Henrik Endeman,Olaf L. Cremer,Sesmu M. Arbous,Alexander P.J. Vlaar
出处
期刊:Transfusion [Wiley]
卷期号:62 (9): 1752-1762 被引量:7
标识
DOI:10.1111/trf.17049
摘要

Transfusion-related acute lung injury (TRALI) is a severe complication of plasma transfusion, though the use of solvent/detergent pooled plasma (SDP) has nearly eliminated reported TRALI cases. The goal of this study was to investigate the incidence of TRALI in intensive care units (ICU) following the replacement of quarantined fresh frozen plasma (qFFP) by SDP.A retrospective multicenter observational before-after cohort study was performed during two 6-month periods, before (April-October 2014) and after the introduction of SDP (April-October 2015), accounting for a washout period. A full chart review was performed for patients who received ≥1 plasma units and developed hypoxemia within 24 h.During the study period, 8944 patients were admitted to the ICU. Exactly 1171 quarantine fresh frozen plasma (qFFP) units were transfused in 376 patients, and respectively, 2008 SDP units to 396 patients after implementation. Ten TRALI cases occurred during the qFFP and nine cases occurred during the SDP period, in which plasma was transfused. The incidence was 0.85% (CI95%: 0.33%-1.4%) per unit qFFP and 0.45% (CI95%: 0.21%-0.79%, p = 0.221) per SDP unit. One instance of TRALI occurred after a single SDP unit. Mortality was 70% for patients developing TRALI in the ICU compared with 22% in patients receiving at least one plasma transfusion.Implementation of SDP lowered the incidence of TRALI in which plasma products were implicated, though not significantly. Clinically diagnosed TRALI can still occur following SDP transfusion. Developing TRALI in the ICU was associated with high mortality rates, therefore, clinicians should remain vigilant.
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