Jones Larry M, Deluga Nicholas, Bhatti Puneet, Scrape Scott R, Bailey John K, Coffey Rebecca A
Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA.
College of Medicine, The Ohio State University, Columbus, OH 43210, USA.
Burns. 2017 Mar;43(2):397-402. doi: 10.1016/j.burns.2016.08.016. Epub 2016 Oct 28.
Resuscitation from burn shock using fresh frozen plasma (FFP) has been described. Critics of FFP resuscitation cite the development of transfusion related acute lung injury (TRALI) as a deterrent to its use. This study examines the occurrence of TRALI with FFP resuscitation of critically ill burned patients.
A retrospective chart review was conducted of severely burned patients who received FFP resuscitation. Data points included age, TBSA, TBSA full thickness, presence of alternate etiologies of acute lung injury, total FFP administered, and signs and symptoms of TRALI as defined per the Canadian Blood Services Consensus Conference.
Eighty-three patients met the definition of severe burn and received FFP resuscitation. Of those, 65 met exclusion criteria. Eighteen patients were left for analysis with only one found to have signs and symptoms of TRALI. That patient suffered a 53.5% TBSA burn, received a total of 6228ml FFP, had no competing etiologies of ALI, and was diagnosed with TRALI within 6h of completing the FFP transfusion.
The possible occurrence of TRALI in burn patients receiving FFP resuscitation should be weighed against the reported benefits of such a resuscitation strategy.
已有关于使用新鲜冰冻血浆（FFP）进行烧伤休克复苏的描述。FFP复苏的批评者指出，输血相关急性肺损伤（TRALI）的发生是阻碍其使用的因素。本研究调查了FFP复苏重症烧伤患者时TRALI的发生情况。
对接受FFP复苏的重度烧伤患者进行回顾性病历审查。数据点包括年龄、烧伤总面积（TBSA）、全层TBSA、急性肺损伤的其他病因、输注的FFP总量以及根据加拿大血液服务共识会议定义的TRALI的体征和症状。
83例患者符合重度烧伤定义并接受了FFP复苏。其中，65例符合排除标准。18例患者留作分析，仅1例出现TRALI的体征和症状。该患者TBSA烧伤达53.5%，共接受6228ml FFP，无ALI的其他病因，且在完成FFP输注后6小时内被诊断为TRALI。
接受FFP复苏的烧伤患者发生TRALI的可能性应与这种复苏策略的已知益处相权衡。
