Transfusion-Related Acute Lung Injury and delayed TRALI: a prospective study in critically ill children

Respiratory problems are common in Pediatric Intensive Care Units (PICU). Transfusions are frequently needed by PICU patients, but the reaction after a transfusion can cause new or worsen pre-existing respiratory problems. The frequency and impact of Transfusion-Related Acute Lung Injury (TRALI) are not well characterized in PICU, while it seems to be one of the major causes of fatal reactions after a transfusion. In this at-risk population, many reactions seem to occur later than usual TRALI (delayed TRALI). This lack of knowledge merits more attention as TRALI and delayed TRALI are associated with poor outcomes in PICU patients. The goal of this project is to determine how frequent TRALI is in PICU patients, after a transfusion. Our hypothesis is that TRALI and delayed TRALI are frequent and severe in critically ill children, and frequently under-recognized. We will also identify the risk factors of TRALI. Five Canadian hospitals will participate in this study in order to include 738 transfused patients over a one-year period and 738 patients who are similar but not exposed to transfusion.The respiratory evolution after the first transfusion will be prospectively evaluated in each transfused patient, and compared to the evolution of non-transfused patients. This study will permit to precise the real frequency, the risk factors, and the evolution of respiratory reaction after a transfusion. These results will be of major importance to develop strategies to improve transfusion safety.

EMERIAUD, Guillaume

Hopital Sainte-Justine

Canadian Blood Services-CIHR Partnership Operating Grant Program

Quebec

$477,651