Delayed presentation of transfusion-related acute lung injury in the emergency department

Delayed transfusion-related acute lung injury

Authors

  • Burak Şahin Attending Physician, Kırşehir Training and Research Hospital, Emergency Medicine Clinic, Kırşehir, Türkiye https://orcid.org/0000-0003-3990-7374
  • Ömer Jaradat Kırşehir Ahi Evran University, Faculty of Medicine, Department of Emergency Medicine, Kırşehir, Türkiye https://orcid.org/0000-0002-6177-710X
  • Zafer Dolu Kırşehir Training and Research Hospital, Emergency Medicine Clinic, Kırşehir, Türkiye https://orcid.org/0000-0001-6665-8620

DOI:

https://doi.org/10.37609/srinmed.46

Keywords:

Transfusion-related acute lung injury, transfusion-associated circulatory overload, Blood products, Transfusion

Abstract

Transfusion-related acute lung injury (TRALI) is a life-threatening complication occurring within 6–72 hours post-transfusion, marked by acute hypoxemia and bilateral pulmonary infiltrates. Delayed TRALI, presenting 6–72 hours after transfusion, is often underrecognized due to its temporal dissociation from the transfusion event. We report an 80-year-old woman with hypertension and atrial fibrillation who developed delayed TRALI 48 hours after receiving erythrocyte suspension for upper gastrointestinal bleeding. She exhibited dyspnoea, hypoxemia, and bilateral pulmonary oedema, without signs of volume overload or infection. Treatment included non-invasive ventilation and diuresis, resulting in rapid recovery. This case underscores the need to consider delayed TRALI in elderly patients with new respiratory symptoms post-transfusion. Early recognition and supportive care are vital, as delayed TRALI can lead to severe respiratory failure. Preventive measures, like using fresher blood units and male-donor plasma, may mitigate risk. Clinicians should maintain a high suspicion for TRALI in high-risk populations to enhance outcomes.

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Published

2025-04-28

How to Cite

1.
Şahin B, Jaradat Ömer, Dolu Z. Delayed presentation of transfusion-related acute lung injury in the emergency department: Delayed transfusion-related acute lung injury. SRINMED [Internet]. 2025 Apr. 28 [cited 2025 May 15];2(1):211-5. Available from: https://journals.akademisyen.net/index.php/srinmed/article/view/46

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Section

Case Report