Acute lung injury after blood transfusion in mechanically ventilated patients.
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.
Gajic
Ognjen
O
Division of Pulmonary and Critical Care Medicine, Mayo Clinic Rochester, Minnesota 55905, USA. Gajic.Ognjen@mayo.edu
Rana
Rimki
R
Mendez
Jose L
JL
Rickman
Otis B
OB
Lymp
James F
JF
Hubmayr
Rolf D
RD
Moore
S Breanndan
SB
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