Transfusion-related acute lung injury (TRALI): Clinical presentation, treatment, and prognosis

2006 ◽  
Vol 34 (Suppl) ◽  
pp. S114-S117 ◽  
Author(s):  
S Breanndan Moore
2010 ◽  
Vol 134 (5) ◽  
pp. 719-727 ◽  
Author(s):  
Mary Beth Beasley

Abstract Context.—Acute lung injury and acute respiratory distress syndrome are significant causes of pulmonary morbidity and are frequently fatal. These 2 entities have precise definitions from a clinical standpoint. Histologically, cases from patients with clinical acute lung injury typically exhibit diffuse alveolar damage, but other histologic patterns may occasionally be encountered such as acute fibrinous and organizing pneumonia, acute eosinophilic pneumonia, and diffuse hemorrhage with capillaritis. Objective.—To review the diagnostic criteria for various histologic patterns associated with a clinical presentation of acute lung injury and to provide diagnostic aids and discuss the differential diagnosis. Data sources.—The review is drawn from pertinent peer-reviewed literature and the author's personal experience. Conclusions.—Acute lung injury remains a significant cause of morbidity and mortality. The pathologist should be aware of histologic patterns of lung disease other than diffuse alveolar damage, which are associated with a clinical presentation of acute lung injury. Identification of these alternative histologic findings, as well as identification of potential etiologic agents, especially infection, may impact patient treatment and disease outcome.


2020 ◽  
Vol 55 (5) ◽  
pp. 2001028 ◽  
Author(s):  
Jordi Rello ◽  
Enrico Storti ◽  
Mirko Belliato ◽  
Ricardo Serrano

Patients with COVID-19 present a broad spectrum of clinical presentation. Whereas hypoxaemia is the marker of severity, different strategies of management should be customised to five specific individual phenotypes. Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxaemia with “normal” (>40 mL·cmH2O−1) lung compliance and likely representing pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin and has low pulmonary compliance, Which is a result of co-infection or acute lung injury after noninvasive ventilation. Identifying these clinical phenotypes and applying a personalised approach would benefit the optimisation of therapies and improve outcomes.


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