[Unclear acute respiratory failure in a 64-year-old woman after coronary intervention]. / Unklare akute respiratorische Insuffizienz bei einer 64-jährigen Patientin nach Koronarintervention.
Dtsch Med Wochenschr
; 135(45): 2235-8, 2010 Nov.
Article
em De
| MEDLINE
| ID: mdl-21046530
ABSTRACT
HISTORY AND ADMISSION FINDINGS:
Due to a retroperitoneal hematoma after cardiac catheterization a 64 year-old woman received two concentrates of red blood cells. Within two hours after transfusion the patient developed acute dyspnoea, anxiety and shivering. INVESTIGATIONS Computertomography (CT) of the chest revealed a new bilateral, basally accented pulmonary edema. Pulmonary embolism was ruled out. A cardiac cause in terms of cardiogenic shock had been excluded by echocardiography and other non-invasive measurements. Moreover, no circulatory overload (transfusion-associated circulatory overload [TACO]) after transfusion was presented and the stable size of the retroperitoneal hematoma excluded haemorrhagic shock. Hence, the clinical pattern pointed towards a transfusion-related acute lung injury (TRALI). TREATMENT AND COURSE The patient was intubated and a catecholamine medication was initiated. The weaning process proceeded without complications and the patient was extubated after several days. In the following chest x-ray no pulmonary residuals were left. After two weeks the patient was transferred to a rehabilitation unit.CONCLUSION:
TRALI is a life-threatening and an often unconsidered complication after transfusion of plasma containing blood products. According to the criteria of the european haemovigilance networks (EHN-criteria), TRALI is diagnosed by clinical and radiological parameters. In case of suspicious TRALI the involved transfusion center has to be informed. By a crossmatch between donor plasma and recipient granulocytes the causal antibodies are detected in most cases. In 17% of cases no antibodies are detected.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Edema Pulmonar
/
Insuficiência Respiratória
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Espaço Retroperitoneal
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Cateterismo Cardíaco
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Transfusão de Eritrócitos
/
Reestenose Coronária
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Stents Farmacológicos
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Lesão Pulmonar Aguda
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Hematoma
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Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
Limite:
Female
/
Humans
/
Middle aged
Idioma:
De
Revista:
Dtsch Med Wochenschr
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Alemanha