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The appearance of hypoxia and bilateral pulmonary infiltrates within 6 hours of blood transfusion suggests a diagnosis of transfusion-related acute lung injury (TRALI). The precise mechanism of TRALI is uncertain, but the lungs are thought to be damaged by antibodies or other harmful substances that accumulate in stored blood. Also, major surgery or trauma seems to sensitize patients to TRALI.
To determine the incidence and outcome of TRALI as well as risk factors for this complication, investigators at a university hospital in the Netherlands performed a nested, case-control study involving a cohort of 486 cardiac surgery patients who received blood products. Patients received chest x-rays when they arrived at the intensive care unit (ICU) …