title: Transfusion-related acute lung injury: lack of recognition because of unawareness of this complication?
abstract: OBJECTIVE
  Transfusion of blood components can trigger immunological reactions which may result in a transfusion-related acute lung injury (TRALI). The reported incidence is low; however, there is increasing evidence that the true incidence of this complication may be much higher. One reason for underdiagnosing TRALI could be a deficiency of knowledge about this complication. Therefore, we studied the level of knowledge concerning TRALI among clinicians working on intensive care units (ICU) of an university teaching hospital.
  
  
  METHODS
  A total of 65 clinicians were asked to complete a confidential questionnaire designed to evaluate their knowledge about incidence, pathophysiology, clinical symptoms, therapy and outcome of TRALI. This questionnaire consisted of 13 questions which could be assessed by 'yes', 'no' or 'do not know'.
  
  
  RESULTS
  Only 42 +/- 18% (mean +/- SD) of all answers were correct, while 33 +/- 17% were wrong and 25 +/- 8% unanswered ('do not know'). The 95% confidence interval for the correct answers was 30.8-53.8% implying that there was no significant difference compared to the probability of arbitrary guessing (33.3%).
  
  
  CONCLUSIONS
  Our survey uncovered a marked deficit of knowledge about TRALI suggesting that the low reported incidence of this complication may be in part due to a lack of awareness for TRALI. We conclude that training programmes for clinicians should alert them to the symptoms, diagnosis and treatment options of TRALI.
authors.affiliation: University Hospital Düsseldorf, Department of Anaesthesiology, Düsseldorf, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Kram
authors.forename: S A
authors.initials: SA
authors.lastname: Loer
mesh_terms: D016913:Blood Component Transfusion / Q000009:adverse effects*; D002983:Clinical Competence; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D012128:Respiratory Distress Syndrome / Q000209:etiology*; D011795:Surveys and Questionnaires