Clinical Experience of Prone Position, PSV, and NIPPV in a Patient with TRALI: Case Report / 대한수혈학회지

ABSTRACT

Transfusion related acute lung injury (TRALI) is rare, but can sometimes lead to serious complication, and increases transfusion related mortality. We report on a case of a 21-year-old female with a femoral arterial rupture. Because of a massive hemorrhage, she was given nine units of packed red blood cell (RBC), nine units of fresh frozen plasma (FFP), and eight units of platelet. One hour after the end of blood transfusion, the patient experienced a sudden onset of dyspnea, tachypnea, cyanosis, and hypoxemia in the recovery room. Her breathing sounds were markedly decreased and bilateral diffuse crackles were detected. There were no signs of volume overload. A chest X-ray showed bilateral coarse alveolar infiltrates and a CT scan showed bilateral non-cardiogenic diffuse pulmonary edema with pleural effusion. Pressure support ventilation (PSV) and noninvasive positive pressure ventilation (NIPPV) were applied via a full-face CPAP mask after changing to prone position. She showed slow improvement, and achieved a full recovery over the next seven days.