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Author (up) Teofili, L.; Bianchi, M.; Zanfini, B.A.; Catarci, S.; Sicuranza, R.; Spartano, S.; Zini, G.; Draisci, G. url  doi
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  Title Acute lung injury complicating blood transfusion in post-partum hemorrhage: incidence and risk factors Type Journal Article
  Year 2014 Publication Mediterranean Journal of Hematology and Infectious Diseases Abbreviated Journal Mediterr J Hematol Infect Dis  
  Volume 6 Issue 1 Pages e2014069  
  Keywords  
  Abstract BACKGROUND: We retrospectively investigated the incidence and risk factors for transfusion-related acute lung injury (TRALI) among patients transfused for post-partum hemorrhage (PPH). METHODS: We identified a series of 71 consecutive patients with PPH requiring the urgent transfusion of three or more red blood cell (RBC) units, with or without transfusion of fresh frozen plasma (FFP) and/or platelets (PLT). Clinical records were then retrieved and examined for respiratory distress events. According to the 2004 consensus definition, cases of new-onset hypoxemia, within 6 hours after transfusion, with bilateral pulmonary changes, in the absence of cardiogenic pulmonary edema were identified as TRALI. If an alternative risk factor for acute lung injury was present, possible TRALI was diagnosed. RESULTS: Thirteen cases of TRALI and 1 case of possible TRALI were identified (overall incidence 19.7%). At univariate analysis, patients with TRALI received higher number of RBC, PLT and FFP units and had a longer postpartum hospitalization. Among the diseases occurring in pregnancy- and various pre-existing comorbidities, only gestational hypertension and pre-eclampsia, significantly increased the risk to develop TRALI (p = 0.006). At multivariate analysis including both transfusion- and patient-related risk factors, pregnancy-related, hypertensive disorders were confirmed to be the only predictors for TRALI, with an odds ratio of 27.7 ( 95% CI 1.27-604.3, p=0.034). CONCLUSIONS: Patients suffering from PPH represent a high-risk population for TRALI. The patients with gestational hypertension and pre-eclampsia, not receiving anti-hypertensive therapy, have the highest risk. Therefore, a careful monitoring of these patients after transfusions is recommended.  
  Address Anesthesiology Department, Universita Cattolica del Sacro Cuore, Rome, Italy  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2035-3006 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:25408855 Approved no  
  Call Number ref @ user @ Serial 64085  
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