Transfusion -Related Acute Lung Injury (TRALI): Incidence, Risk Factors and Outcome in The Cardiothoracic Intensive Care Unit

BACKGROUND: Transfusion –related acute lung injury (TRALI) is a life threatening complication of blood transfusion.  Cardiac surgery under cardiopulmonary bypassis a risk factor for acute lung injury(ALI) . The term‟ possible TRALI ” is used when there are alternative risk  factors for ALI in addition to blood transfusion. OBJECTIVES OF THE STUDY: To determine the incidence, outcome and risk factors of‟ possible TRALI ”  in the cardiothoracic intensive care unit. MATERIALS AND METHODS: It was an observational prospective cohort study in patients who underwent cardiac surgery  and received perioperative blood transfusion.Perioperative patient related,surgery related and transfusion related data  were recorded. RESULTS: The incidence of ‟possible TRALI” was 5.4%.  The APACHE 2 score (p= 0.032) and platelet transfusion (p=0.035) was significantly higher for the ‟possible TRALI” group compared to the no lung injury group. There was no mortality. The duration ofventilation and ICU stay was comparable between both the groups. CONCLUSION: The incidence of possible TRALI is high (5.4%) in cardiac surgery. The occurrence of TRALI is highest for platelet transfusion.