Platelet Transfusion Associated With Acute Lung Injury After Coronary Artery Bypass Grafting

Transfusion-related acute lung injury is a potentially fatal complication of blood and plasma transfusion; however, the incidence relating to platelet use in cardiac surgery is uncommon. In the presence of normal left ventricular function, an acute increase in pulmonary capillary permeability leads to a high protein content pulmonary edema, which leads to a dramatic reduction in pulmonary function due to acute lung injury and also intravascular fluid depletion. The clinical picture is acute and the condition is associated with considerable mortality. Although the exact mechanism of transfusion-related acute lung injury is unknown, it may be due to an antibody-mediated reaction caused by preformed leukocyte antibodies or activation of inflammatory mediators. The signs, diagnosis, and therapeutic interventions are discussed with reference to a case report. (Ann Thorac Surg 2011;91:1977-9) (C) 2011 by The Society of Thoracic Surgeons