High-frequency oscillatory ventilation for rescue from refractory hypoxemia in a patient with transfusion-related acute lung injury.

ABSTRACT

Transfusion-related acute lung injury is a serious complication of blood transfusions. Herein is a report on a 32-year-old woman who developed diffuse pulmonary infiltrates and acute respiratory compromise after blood transfusion. Non-cardiogenic pulmonary edema was diagnosed based on data calculated by the hemodynamic monitoring system, but severe hypoxemia persisted despite conventional pressure-control ventilation with 100% oxygen, low tidal volume, and high PEEP. The refractory hypoxemia was improved by high-frequency oscillatory ventilation. This experience suggests that high-frequency oscillatory ventilation may be beneficial for patients with transfusion-related acute lung injury and severe refractory hypoxemia.