| [Unclear acute respiratory failure in a 64-year-old woman after coronary intervention]. | |
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MedLine Citation:
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PMID: 21046530 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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V Tiyerili; U M Becher; K Strach; C F Mueller; G Nickenig; J O Schwab |
Publication Detail:
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Type: Case Reports; English Abstract; Journal Article Date: 2010-11-02 |
Journal Detail:
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Title: Deutsche medizinische Wochenschrift (1946) Volume: 135 ISSN: 1439-4413 ISO Abbreviation: Dtsch. Med. Wochenschr. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-03 Completed Date: 2010-11-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0006723 Medline TA: Dtsch Med Wochenschr Country: Germany |
Other Details:
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Languages: ger Pagination: 2235-8 Citation Subset: IM |
Copyright Information:
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© Georg Thieme Verlag KG Stuttgart · New York. |
Affiliation:
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Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn, Germany. Vedat.Tiyerili@ukb.uni-bonn.de |
Vernacular Title:
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Unklare akute respiratorische Insuffizienz bei einer 64-jährigen Patientin nach Koronarintervention. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Lung Injury
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diagnosis*,
therapy Catecholamines / administration & dosage Combined Modality Therapy Coronary Restenosis / therapy* Drug-Eluting Stents* Echocardiography Erythrocyte Transfusion / adverse effects* Female Heart Catheterization / adverse effects* Hematoma / etiology*, therapy* Humans Intermediate Care Facilities Intubation, Intratracheal Middle Aged Myocardial Infarction / therapy* Myocardial Revascularization* Pulmonary Edema / diagnosis, etiology*, therapy Respiratory Insufficiency / diagnosis, etiology*, therapy Retroperitoneal Space* Tomography, X-Ray Computed Ventilator Weaning |
| Chemical | |
Reg. No./Substance:
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0/Catecholamines |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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