Transfusion-related acute lung injury in a case of acute ruptured ectopic pregnancy

Abstract

Transfusion-related acute lung injury (TRALI) is a clinical syndrome typically presenting as an acute respiratory distress characterized by dyspnea, hypoxemia, and bilateral non-cardiogenic pulmonary edema, developing within 6 h of transfusion of as little as 50 mL of blood product. TRALI may occur as a result of passive transfer of antibodies against leukocytes or tissue antigens and/or biological response modifiers from any donor blood product, resulting in damage to the recipient's pulmonary vasculature. Although, in most of the cases, recovery is quick and complete, severe cases may require prolonged ventilatory support. TRALI can be fatal if urgent intervention is not undertaken and carries the highest fatality among all transfusion-related reactions. The blood banks need to identify donors whose plasma contains antibodies implicated in TRALI, in order to prevent its occurrence. We describe a case of TRALI following the transfusion of 200 mL of whole blood in a 35-year-old female diagnosed with an acutely ruptured ectopic pregnancy. She recovered after intensive management with ventilator and hemodynamic support.