title: Acute lung injury after blood transfusion in mechanically ventilated patients.
abstract: BACKGROUND
  Liberal transfusion strategy increases the risk of acute lung injury (ALI), but specific transfusion-related factors have not been characterized. We tested the hypotheses that storage age and specific type of blood products are associated with increased risk of ALI in mechanically ventilated patients.
  
  
  METHODS
  From a database of mechanically ventilated patients, we identified those who received blood products during the first 48 hours of intensive care. We extracted information about underlying ALI risk factors as well as the type, amount, and shelf age of administered blood products. Outcome was assessed by an independent, blind review of chest radiographs and clinical findings.
  
  
  RESULTS
  Of 181 patients transfused during the first 48 hours of mechanical ventilation, 60 (33%) developed ALI. There was no difference in average duration of red blood cells storage between patients who did and did not develop ALI (median, 18.5 vs. 17.5 days; p = 0.22). In a multivariable logistic regression analysis, important risk factors associated with the development of ALI were thrombocytopenia (odds ratio, 5.9; p = 0.004) and transfusion of fresh frozen plasma (odds ratio, 3.2; p = 0.023).
  
  
  CONCLUSIONS
  Thrombocytopenia and transfusion of fresh frozen plasma, but not storage age of red blood cells, were associated with the development of ALI in this cohort of mechanically ventilated patients.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Minnesota 55905, USA. Gajic.Ognjen@mayo.edu
authors.forename: Ognjen
authors.initials: O
authors.lastname: Gajic
authors.forename: Rimki
authors.initials: R
authors.lastname: Rana
authors.forename: Jose L
authors.initials: JL
authors.lastname: Mendez
authors.forename: Otis B
authors.initials: OB
authors.lastname: Rickman
authors.forename: James F
authors.initials: JF
authors.lastname: Lymp
authors.forename: Rolf D
authors.initials: RD
authors.lastname: Hubmayr
authors.forename: S Breanndan
authors.initials: SB
authors.lastname: Moore
mesh_terms: D000368:Aged; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001793:Blood Preservation / Q000009:adverse effects; D001800:Blood Specimen Collection; D004912:Erythrocytes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010949:Plasma; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000150:complications