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2015 | 11 | 3 | 250–258
Article title

Ostre poprzetoczeniowe uszkodzenie płuc – często nierozpoznawana reakcja po przetoczeniu składników krwi

Content
Title variants
EN
Transfusion-related acute lung injury – a frequently undiagnosed reaction following transfusion of blood components
Languages of publication
EN PL
Abstracts
EN
Transfusion-related acute lung injury is the leading cause of mortality following transfusion of blood components. Its characteristic feature is acute hypoxaemia during or 6 hours after transfusion. The syndrome should be differentiated from cardiogenic respiratory failure and transfusion-associated circulatory overload. This article presents: 1) The aetiology and pathomechanism of transfusion-related acute lung injury, which are still not fully understood despite numerous studies. The model currently accepted is the multi-event one which involves both factors related to the patient and to the transfused blood components. Transfusion-related acute lung injury may be either immunological, with anti-HLA/HNA antibodies in blood components, or non-immunological, with no antibodies. 2) The diagnosis of transfusion-related acute lung injury which is based on clinical signs, evidence of the relationship with blood component transfusion and detection of antibodies. 3) The treatment and prevention of transfusion-related acute lung injury. The most important element in the prevention of transfusion-related acute lung injury is a reduction in blood component transfusion, particularly of plasma and platelet concentrate. Yet, further studies on larger groups of patients are necessary to specify the limitations of blood component transfusion.
PL
Poprzetoczeniowe ostre uszkodzenie płuc jest jedną z najważniejszych przyczyn śmierci związanych z przetaczaniem składników krwi. Charakteryzuje się ostrym niedotlenieniem podczas przetaczania lub 6 godzin po nim i wymaga różnicowania z kardiogenną niewydolnością oddechową oraz poprzetoczeniowym przeciążeniem krążenia. W artykule przedstawiono: 1) Etiologię i patomechanizm poprzetoczeniowego ostrego uszkodzenia płuc, z podkreśleniem, że jest ona wciąż nie do końca poznana. Ostatnio zaakceptowano wielozdarzeniową patogenezę, która obejmuje czynniki pochodzące zarówno od chorego, jak i ze składników krwi. Poprzetoczeniowe ostre uszkodzenie płuc może być immunologiczne, z obecnością przeciwciał anty-HLA/HNA w przetoczonej krwi, lub nieimmunologiczne, bez wykrywanych przeciwciał. 2) Rozpoznanie poprzetoczeniowego ostrego uszkodzenia płuc – oparte jest na stwierdzanych objawach klinicznych i wykazaniu związku z przetoczeniem składników krwi oraz oznaczeniu obecności przeciwciał. 3) Leczenie i zapobieganie występowaniu poprzetoczeniowego ostrego uszkodzenia płuc – w profilaktyce poprzetoczeniowego ostrego uszkodzenia płuc największe znaczenie ma ograniczenie przetaczania składników krwi, szczególnie osocza i koncentratów krwinek płytkowych. Do sformułowania ostatecznych wniosków dotyczących ograniczenia przetoczeń konieczne są jednak badania przeprowadzone na dużej populacji chorych z różnymi chorobami.
Discipline
Publisher

Year
Volume
11
Issue
3
Pages
250–258
Physical description
Contributors
  • Zakład Transfuzjologii Klinicznej, Wojskowy Instytut Medyczny, Warszawa. Kierownik Zakładu: dr hab. n. med. Jolanta Korsak, prof. nadzw. WIM, ul. Szaserów 128, 04-141 Warszawa, zt@wim.mil.pl
author
  • Zakład Transfuzjologii Klinicznej, Wojskowy Instytut Medyczny, Warszawa. Kierownik Zakładu: dr hab. n. med. Jolanta Korsak, prof. nadzw. WIM
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Document Type
review
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.psjd-54a2132a-a622-4009-8d20-87b653d7f91b
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