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预防输血相关急性肺损伤(TRALI)的献血者及血液成分管理策略

Blood donor and component management strategies to prevent transfusion-related acute lung injury (TRALI).

作者信息

Mair D C, Hirschler Nora, Eastlund Ted

机构信息

American Red Cross-North Central Blood Services, St. Paul, MN, USA.

出版信息

Crit Care Med. 2006 May;34(5 Suppl):S137-43. doi: 10.1097/01.CCM.0000214291.93884.BB.

Abstract

OBJECTIVE

Discuss the pros and cons of using donor and blood product-management strategies to prevent transfusion-related acute lung injury (TRALI).

DATA SOURCE

A review of the literature was performed.

RESULTS

Despite therapeutic advances in pulmonary and critical care medicine, TRALI is now considered to be one of the leading causes of transfusion-associated mortality, and thus determining how to prevent TRALI is extremely important. Donor and product-management strategies to prevent this life-threatening condition have been suggested, but because of gaps in our understanding of TRALI, blood-bankers do not know how beneficial these interventions will be, nor the amount of potential harm-such as decreasing the availability of blood-that could arise if they were implemented. This article discusses the advantages and disadvantages of the various preventive measures that have been described in the literature.

CONCLUSIONS

Preventing TRALI poses a difficult challenge for blood-banking experts, because it is unknown which measures will be effective in decreasing the incidence of TRALI and which could have significant drawbacks. Only additional research into TRALI prevention will provide the answers on how to best protect patients from this potentially fatal reaction.

摘要

目的

探讨采用供体及血液制品管理策略预防输血相关急性肺损伤(TRALI)的利弊。

数据来源

进行了文献综述。

结果

尽管肺部和重症医学在治疗方面取得了进展,但TRALI目前被认为是输血相关死亡的主要原因之一,因此确定如何预防TRALI极其重要。已有人提出预防这种危及生命状况的供体及制品管理策略,但由于我们对TRALI的认识存在差距,血库工作人员不知道这些干预措施会有多大益处,也不清楚如果实施这些措施可能会造成何种潜在危害,比如减少血液供应。本文讨论了文献中描述的各种预防措施的优缺点。

结论

预防TRALI对血库专家来说是一项艰巨的挑战,因为尚不清楚哪些措施能有效降低TRALI的发生率,哪些措施可能有严重弊端。只有对TRALI预防进行更多研究,才能找到如何最好地保护患者免受这种潜在致命反应影响的答案。

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