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Review ArticleSystematic Review

Risk Factors for Transfusion-Related Acute Lung Injury

Lunyang Hu, Baoli Wang, Yong Jiang, Banghui Zhu, Chen Wang, Qing Yu, Wenjia Hou, Zhaofan Xia, Guosheng Wu and Yu Sun
Respiratory Care June 2021, 66 (6) 1029-1038; DOI: https://doi.org/10.4187/respcare.08829
Lunyang Hu
Department of Burn Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China.
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Baoli Wang
Department of Burn Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China.
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Yong Jiang
Department of Burn Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China.
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Banghui Zhu
Department of Burn Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China.
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Chen Wang
Department of Burn Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China.
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Qing Yu
Department of Burn Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China.
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Wenjia Hou
Department of Burn Surgery, First Affiliated Hospital of Naval Medical University, Shanghai, People’s Republic of China.
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Zhaofan Xia
Burn and Trauma Center, Changhai Hospital, Shanghai, People’s Republic of China.
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  • For correspondence: [email protected]
Guosheng Wu
Burn and Trauma Center, Changhai Hospital, Shanghai, People’s Republic of China.
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Yu Sun
Burn and Trauma Center, Changhai Hospital, Shanghai, People’s Republic of China.
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Abstract

BACKGROUND: Until now, transfusion-related acute lung injury (TRALI) has been considered the leading cause of blood transfusion-related diseases and death. In addition, there is no clinically effective treatment plan for TRALI. The aim of this study was to systematically summarize the literature on risk factors for TRALI in critical patients.

METHODS: Electronic searches (up to March 2020) were performed in the Cochrane Library, Web of Knowledge, Embase, and PubMed databases. We included studies reporting on the risk factors of TRALI for critical patients and extracted risk factors. A total of 13 studies met the inclusion criteria.

RESULTS: We summarized and analyzed the potential risk factors of TRALI for critical patients in 13 existing studies. Host-related factors were age (odds ratio [OR] 1.16 [95% CI 1.08–1.24]), female sex (OR 1.26 [95% CI 1.16–1.38]), tobacco use status (OR 3.82 [95% CI 1.91–7.65]), chronic alcohol abuse (OR 3.82 [95% CI 2.97–26.83]), positive fluid balance (OR 1.24 [95% CI 1.08-1.42]), shock before transfusion (OR 4.41 [95% CI 2.38–8.20]), and American Society of Anesthesiologists (ASA) score of the recipients (OR 2.72 [95% CI 1.43–5.16]). The transfusion-related factors were the number of transfusions (OR 1.40 [95% CI 1.14–1.72]) and units of fresh frozen plasma (OR 1.21 [95% CI 1.01–1.46]). The device-related factor was mechanical ventilation (OR 4.13 [95% CI 2.20–7.76]).

CONCLUSIONS: The risk factors that were positively correlated with TRALI in this study included number of transfusions and units of fresh frozen plasma. Age, female sex, tobacco use, chronic alcohol abuse, positive fluid balance, shock before transfusion, ASA score, and mechanical ventilation may be potential risk factors for TRALI. Our results suggest that host-related risk factors may play a more important role in the occurrence and development of TRALI than risk factors related to blood transfusions.

  • TRALI
  • ICU
  • risk factors
  • predictors

Footnotes

  • Correspondence: Zhaofan Xia. E-mail: xiazhaofan_smmu{at}163.com
  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • This work was supported by the National Natural Science Foundation of China (81930057, 81772076), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-076), and Achievements Supportive Fund (2018-CGPZ-B03). The authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
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Respiratory Care: 66 (6)
Respiratory Care
Vol. 66, Issue 6
1 Jun 2021
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Risk Factors for Transfusion-Related Acute Lung Injury
Lunyang Hu, Baoli Wang, Yong Jiang, Banghui Zhu, Chen Wang, Qing Yu, Wenjia Hou, Zhaofan Xia, Guosheng Wu, Yu Sun
Respiratory Care Jun 2021, 66 (6) 1029-1038; DOI: 10.4187/respcare.08829

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Risk Factors for Transfusion-Related Acute Lung Injury
Lunyang Hu, Baoli Wang, Yong Jiang, Banghui Zhu, Chen Wang, Qing Yu, Wenjia Hou, Zhaofan Xia, Guosheng Wu, Yu Sun
Respiratory Care Jun 2021, 66 (6) 1029-1038; DOI: 10.4187/respcare.08829
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