Transfusion-related acute lung injury (TRALI) is uncommon, it begins 6 hours post the start of a blood transfusion. 90% of cases are immune mediated with reactions to anti-HLA or other antibodies in the donor blood.

When this is not the cause a non-immunological mechanism is suspected to be the cause of the reaction. This is probably triggered by and inflammatory cascade with lipids found in blood products.

Pathophysiology:

Non-cardiogenic pulmonary oedema thought to be secondary to increased vascular permeability caused by host neutrophils that become activated by substances in donated blood

PC

• Dyspnoea/ tachypnoea
• Cough
• Fever
• Hypotension.

investigations

Bedside:

• hypoxaemia
• hypotension

Imaging:

• pulmonary infiltrates visible on a chest x-ray.

Management