High-Frequency Oscillatory Ventilation for Rescue From Refractory Hypoxemia in a Patient With Transfusion-Related Acute Lung Injury

• Published in: Respiratory care Vol. 57; no. 5; pp. 798 - 801
• Main Authors: HUANG, Chin-Hua, HU, Han-Chung, HSIEH, Meng-Jer, HUANG, Ching-Tzu, CHO, Hsiu-Ying, HSIAO, Hsiu-Feng, YANG, Cheng-Ta, TSAI, Ying-Huang, HUANG, Chung-Chi, KAO, Kuo-Chin
• Format: Journal Article
• Language: English
• Published: Irving, TX Daedalus 01.05.2012; Daedalus Enterprises, Inc
• Subjects: Acute Lung Injury - diagnosis; Acute Lung Injury - etiology; Acute Lung Injury - therapy; Acute respiratory distress syndrome; Adult; Anemia - therapy; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Artificial respiration; Biological and medical sciences; Blood transfusion; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Care and treatment; Case studies; Complications and side effects; Female; Health aspects; High-Frequency Ventilation; Humans; Hypoxia - diagnosis; Hypoxia - etiology; Hypoxia - therapy; Intensive care medicine; Medical sciences; Transfusion Reaction; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Human; transfusion-related lung injure; Lung disease; Rescue; Oxygen; Intensive care; refractory hypoxemia; Transfusion; Respiratory disease; Hypoxemia; high-frequency oscillatory ventilation; High frequency ventilation; Resuscitation
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.01355

Transfusion-related acute lung injury is a serious complication of blood transfusions. Herein is a report on a 32-year-old woman who developed diffuse pulmonary infiltrates and acute respiratory compromise after blood transfusion. Non-cardiogenic pulmonary edema was diagnosed based on data calculated by the hemodynamic monitoring system, but severe hypoxemia persisted despite conventional pressure-control ventilation with 100% oxygen, low tidal volume, and high PEEP. The refractory hypoxemia was improved by high-frequency oscillatory ventilation. This experience suggests that high-frequency oscillatory ventilation may be beneficial for patients with transfusion-related acute lung injury and severe refractory hypoxemia.