title: TRALI following fresh frozen plasma resuscitation from burn shock.
abstract: BACKGROUND
  Resuscitation from burn shock using fresh frozen plasma (FFP) has been described. Critics of FFP resuscitation cite the development of transfusion related acute lung injury (TRALI) as a deterrent to its use. This study examines the occurrence of TRALI with FFP resuscitation of critically ill burned patients.
  
  
  METHODS
  A retrospective chart review was conducted of severely burned patients who received FFP resuscitation. Data points included age, TBSA, TBSA full thickness, presence of alternate etiologies of acute lung injury, total FFP administered, and signs and symptoms of TRALI as defined per the Canadian Blood Services Consensus Conference.
  
  
  RESULTS
  Eighty-three patients met the definition of severe burn and received FFP resuscitation. Of those, 65 met exclusion criteria. Eighteen patients were left for analysis with only one found to have signs and symptoms of TRALI. That patient suffered a 53.5% TBSA burn, received a total of 6228ml FFP, had no competing etiologies of ALI, and was diagnosed with TRALI within 6h of completing the FFP transfusion.
  
  
  CONCLUSIONS
  The possible occurrence of TRALI in burn patients receiving FFP resuscitation should be weighed against the reported benefits of such a resuscitation strategy.
authors.affiliation: Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA. Electronic address: Larry.jones@osumc.edu.
authors.forename: Larry M
authors.initials: LM
authors.lastname: Jones
authors.affiliation: College of Medicine, The Ohio State University, Columbus, OH 43210, USA. Electronic address: Nicholas.Deluga@osumc.edu.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Deluga
authors.affiliation: The Ohio State University, Columbus, OH 43210, USA. Electronic address: bhatti.16@buckeyemail.osu.edu.
authors.forename: Puneet
authors.initials: P
authors.lastname: Bhatti
authors.affiliation: Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA. Electronic address: Scott.scrape@osumc.edu.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Scrape
authors.affiliation: Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA. Electronic address: john.bailey@osumc.edu.
authors.forename: John K
authors.initials: JK
authors.lastname: Bailey
authors.affiliation: Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA. Electronic address: Rebecca.coffey@osumc.edu.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Coffey
mesh_terms: D055371:Acute Lung Injury / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000368:Aged; D016913:Blood Component Transfusion / Q000009:adverse effects*; D002056:Burns / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010949:Plasma; D012151:Resuscitation; D012189:Retrospective Studies; D012769:Shock / Q000209:etiology / Q000628:therapy*; D014481:United States / Q000453:epidemiology
keywords: Burn shock resuscitation; Fresh frozen plasma; TRALI