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. STUDY DESIGN AND 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). CONCLUSION: 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.
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. STUDY DESIGN AND 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). CONCLUSION: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: Daryl J Kor; Rahul Kashyap; Richard B Weiskopf; Gregory A Wilson; Camille M van Buskirk; Jeffrey L Winters; Michael Malinchoc; Rolf D Hubmayr; Ognjen Gajic Journal: Am J Respir Crit Care Med Date: 2012-01-26 Impact factor: 21.405
Authors: Richard B Weiskopf; John Feiner; Pearl Toy; Jenifer Twiford; David Shimabukuro; Jeremy Lieberman; Mark R Looney; Clifford A Lowell; Michael A Gropper Journal: Anesth Analg Date: 2012-01-19 Impact factor: 5.108
Authors: David J Murphy; David Howard; Angela Muriithi; Pedro Mendez-Tellez; Jonathan Sevransky; Carl Shanholtz; Giora Netzer; Peter J Pronovost; Dale M Needham Journal: Crit Care Med Date: 2009-06 Impact factor: 7.598