Anesth Pain Med.  2019 Jan;14(1):35-39. 10.17085/apm.2019.14.1.35.

Transfusion-related acute lung injury in a parturient diagnosed with myelodysplastic syndrome: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Konyang University College of Medicine, Daejeon, Korea. jisaac@naver.com

Abstract

Transfusion-related acute lung injury (TRALI) is defined as a new episode of acute lung injury that occurs during or within 6 hours of a completed transfusion, which is one of the leading causes of transfusion-related morbidity and mortality. We present a case of TRALI in a 29-year-old parturient with myelodysplastic syndrome scheduled for cesarean section. The parturient developed hypoxemia and dyspnea after preoperative transfusion of platelets following apheresis to eliminate a unit of leucocyte in order to correct thrombocytopenia. She underwent emergent caesarean section for fetal distress. After surgery, the chest radiograph showed diffuse haziness of both lung fields. Direct and indirect antiglobulin tests were negative, and hemolytic transfusion reaction was ruled out. Pro-BNP 347.3 pg/ml also excluded transfusion-associated circulatory overload. The parturient completely recovered after oxygen support for 2 days. It is important to recognize TRALI as soon as possible to minimize perioperative morbidity and mortality.

Keyword

Cesarean section; Dyspnea; Myelodysplastic syndrome; Transfusion-related acute lung injury

MeSH Terms

Acute Lung Injury*
Adult
Anoxia
Blood Component Removal
Cesarean Section
Coombs Test
Dyspnea
Female
Fetal Distress
Humans
Lung
Mortality
Myelodysplastic Syndromes*
Oxygen
Pregnancy
Radiography, Thoracic
Thrombocytopenia
Transfusion Reaction
Oxygen
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