GKD Anest Yoð Bak Dern Derg. 2017; 23(1): 26-31 | DOI: 10.5222/GKDAD.2017.026

Noninvasive-Mechanical Ventilation Experience of Transfusion Related Acute Lung Injury (TRALI) after The Patient Undergoing Supracoronary Graft Interposition due to Ascending Aortic Aneurysm

Harun Özmen¹, Bahar Aydýnlý¹, Ali Gül², Özden Vezir², Necmi Köse^2
1Department of Anaesthesiology and Reanimation, Mersin Public Hospital, Mersin
²Department of Cardiovascular Surgery, Mersin Public Hospital, Mersin

Transfusion-related acute lung injury (TRALI) is second important the leading cause of transfusion-associated mortality in high-risk patients undergoing major surgery. TRALI presented with acute hypoxia and non-cardiac edema is a vital clinical entity which must be considered in differential diagnosis in transfusion-associated patients. Fresh frozen plasma, erythrocyte suspension and thrombocyte suspension transfusion was performed perioperative and postoperative to the patient undergoing supracoronary graft interposition due to ascending aortic aneurysm. Respiratory support treatment with positive pressure mechanical ventilation was began for acute hypoxia and bilateral pulmonary edema developed immediately after. The patient thougth to be delayed TRALI was extubated postoperative day 5. Non-invasive mechanical respiratory support treatment was proceeded. The oxygen and ventilatory support need has been completely eliminated postoperative day 10. TRALI should be considered in patients with acute onset of hypoxia, ARDS especially undergoing major surgery and transfused large amounts of ES, FFP, trombocyte suspension. Noninvasive-mechanical ventilation option should be considered as a treatment.

Key words: Blood Component Transfusion; Aortic Aneurysm

Keywords: Blood component transfusion, aortic aneurysm, pulmonary edema

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Asendan aort anevrizmalý hastada greft interpozisyonu sonrasý geliþen TRALI ve noninvaziv mekanik ventilasyon deneyimi

Harun Özmen¹, Bahar Aydýnlý¹, Ali Gül², Özden Vezir², Necmi Köse^2
1Mersin Devlet Hastanesi Anesteziyoloji Ve Reanimasyon Kliniði, MERSÝN
²Mersin Devlet Hastanesi Kalp Damar Cerrahisi Kliniði,MERSÝN

Transfüzyona baðlý akut akciðer hasarý (TRALI), major cerrahi geçiren yüksek riskli hasta grubunda tarnsfüzyona baðlý ölümlerin ikinci en sýk sebebidir. Akut hipoksi ve nonkardiyojenik pulmoner ödem tablosu ile ortaya çýkan TRALI, transfüzyon yapýlan hastalarda ayýrýcý tanýda düþünülmesi gereken önemli bir klinik tablodur. Asendan aort anevrizmalý suprakoroner greft interpozisyonu yapýlan hastaya perioperatif ve postoperatif TDP, ES ve trombosit transfüzyonu yapýldý. Sonrasýnda akut geliþen hipoksi ve bilateral akciðer ödemini takiben pozitif basýnçlý mekanik ventilasyon ile solunum destek tedavisi baþlandý. Gecikmiþ TRALI olarak düþünülen hasta postop 5.günde ekstübe edildi. Non invaziv mekanik solunum desteðine devam edildi. Onuncu günde oksijen ve solunum destek ihtiyacý tamamen ortadan kalktý. Özellikle major cerrahi geçiren, yüksek miktarda ES,TDP, trombosit süspansiyonu transfüse edilen hastalarda akut geliþen hipoksi, ARDS tablosunda TRALI akla gelmeli, tedavide noninvaziv mekanik ventilasyon seçeneði düþünülmelidir.
AnahtarKelimeler: kan elemanlarý transfüzyonu; Aort anevrizmasý

Anahtar Kelimeler: Kan elemanlarý transfüzyonu, aort anevrizmasý, akciðer ödemi

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