title: [Respiratory complications after transfusion].
abstract: Respiratory complications of blood transfusion have several possible causes. Transfusion-Associated Circulatory Overload (TACO) is often the first mentioned. Transfusion-Related Acute Lung Injury (TRALI), better defined since the consensus conference of Toronto in 2004, is rarely mentioned. French incidence is low. Non-hemolytic febrile reactions, allergies, infections and pulmonary embolism are also reported. The objective of this work was to determine the statistical importance of the different respiratory complications of blood transfusion. This work was conducted retrospectively on transfusion accidents in six health centers in Champagne-Ardenne, reported to Hemovigilance between 2000 and 2009 and having respiratory symptoms. The analysis of data was conducted by an expert committee. Eighty-three cases of respiratory complications are found (316,864 blood products). We have counted 26 TACO, 12 TRALI (only 6 cases were identified in the original investigation of Hemovigilance), 18 non-hemolytic febrile reactions, 16 cases of allergies, 5 transfusions transmitted bacterial infections and 2 pulmonary embolisms. Six new TRALI were diagnosed previously labeled TACO for 2 of them, allergy and infection in 2 other cases and diagnosis considered unknown for the last 2. Our study found an incidence of TRALI 2 times higher than that reported previously. Interpretation of the data by a multidisciplinary committee amended 20% of diagnoses. This study shows the imperfections of our system for reporting accidents of blood transfusion when a single observer analyses the medical records.
authors.affiliation: Pôle anesthésie-réanimation médecine d'urgence, hôpital Sud, CHU d'Amiens, avenue Laënnec, 80001 Amiens, France. Electronic address: m.bernasinski@orange.fr.
authors.forename: M
authors.initials: M
authors.lastname: Bernasinski
authors.affiliation: Service d'anesthésie-réanimation chirurgicale, nouvel hôpital civil, hôpitaux universitaires de Strasbourg, BP 426, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
authors.forename: P-M
authors.initials: PM
authors.lastname: Mertes
authors.affiliation: Unité d'hémovigilance, Agence nationale de sécurité du médicament et des produits de santé (ANSM), 143, boulevard Anatole-France, 93285 Saint-Denis cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Carlier
authors.affiliation: Pôle anesthésie-réanimation médecine d'urgence, hôpital Sud, CHU d'Amiens, avenue Laënnec, 80001 Amiens, France.
authors.forename: H
authors.initials: H
authors.lastname: Dupont
authors.affiliation: Service d'anesthésie-réanimation, clinique de Courlancy, 38, rue de Courlancy, 51100 Reims, France.
authors.forename: M
authors.initials: M
authors.lastname: Girard
authors.affiliation: Pôle anesthésie-réanimation, hôpital Bon-Secours, CHR de Metz-Thionville, 1, place Philippe-de-Vigneulles, 57000 Metz, France.
authors.forename: S
authors.initials: S
authors.lastname: Gette
authors.affiliation: Réanimation polyvalente, hôpital Manchester, 45, avenue de Manchester, 08011 Charleville-Mézières, France.
authors.forename: B
authors.initials: B
authors.lastname: Just
authors.affiliation: Pôle urgence réanimation-anesthésie et douleur, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Malinovsky
mesh_terms: D058731:Blood Safety / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008168:Lung / Q000473:pathology*; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D065227:Transfusion Reaction
keywords: Allergie; Allergy; Febrile non-hemolytic reactions; Haemovigilance; Hémovigilance; Réactions fébriles non hémolytiques; TACO; TRALI; Toronto; Transfusion