Journal
INTENSIVE CARE MEDICINE
Volume 46, Issue 12, Pages 2450-2457Publisher
SPRINGER
DOI: 10.1007/s00134-020-06303-z
Keywords
Acute respiratory distress syndrome; Anemia; Hypervolemia; Inflammatory response; Oxygen delivery; Transfusion-associated circulatory overload; Transfusion-related acute lung injury
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Red blood cell transfusions are a frequent intervention in critically ill patients, including in those who are receiving mechanical ventilation. Both these interventions can impact negatively on lung function with risks of transfusion-related acute lung injury (TRALI) and other forms of acute respiratory distress syndrome (ARDS). The interactions between transfusion, mechanical ventilation, TRALI and ARDS are complex and other patient-related (e.g., presence of sepsis or shock, disease severity, and hypervolemia) or blood product-related (e.g., presence of antibodies or biologically active mediators) factors also play a role. We propose several strategies targeted at these factors that may help limit the risks of associated lung injury in critically ill patients being considered for transfusion.
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