Ostra poprzetoczeniowa niewydolność oddechowa jako możliwe powikłanie wstrząsu hipowolemicznego spowodowanego krwawieniem z przewodu pokarmowego. Opis przypadku

Waldemar Machała

Summary
Background. Transfusion-related acute lung injury (TRALI) is the third most common complication of blood and blood products transfusion with an incidence rate of 7%, and a mortality rate of between 5 and 13%. Case report. TRALI developed in a 58-yr-old male patient, who underwent surgery for gastrointestinal bleeding and received 6 units of packed red cells and 6 units of fresh frozen plasma. Since we did not find anti-HAL antibodies in donor preparations or in recipient plasma, the diagnosis was made from a clinical picture (respiratory distress, pulmonary oedema). During subsequent treatment, the patient was transfused three times with leukocyte-depleted packed red cells and 20% albumin solution. No other blood products were given. He died after 29 days because of multiple organ failure and sepsis. Discussion. There is no specific treatment for TRALI; 70% of patients require intensive care and mechanical ventilation. Diuretics and corticosteroids should not be given. It is difficult to be certain that the respiratory distress in this case developed due to transfusion of blood components or was a result of the underlying disease.

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