Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients

Hasrat Khan, Jon Belsher, Murat Yilmaz, Bekele Afessa, Jeffrey L. Winters, S. Breanndan Moore, Rolf D. Huhmayr, Ognjen Gajic

Research output: Research - peer-reviewArticle

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Abstract

Background: Transfusion has long been identified as a risk factor for acute lung injury (ALI)/ARDS. No study has formally evaluated the transfusion of specific blood products as a risk factor for ALI/ARDS in critically ill medical patients. Method: In this single-center retrospective cohort study, 841 consecutive critically ill patients were studied for the development of ALI/ARDS. Patients who received blood product transfusions were compared with those who did not, in univariate and multivariate propensity analyses. Results: Two hundred ninety-eight patients (35%) received blood transfusions. Transfused patients were older (mean [± SD] age, 67 ± 17 years vs 62 ± 19 years; p < 0.001) and had higher acute physiologic and chronic health evaluation (APACHE) III scores (74 ± 32 vs 58 ± 23; p < 0.001) than those who had not received transfusions. ALI/ARDS developed more commonly (25% vs 18%; p = 0.025) in patients exposed to transfusion. Seventeen patients received massive MBC transfusions (ie, > 10 U of blood transfused within 24 h), of whom 13 also received fresh-frozen plasma (FFP) and 11 received platelet transfusions. When adjusted for the probability of transfusion and other ALI/ARDS risk factors, any transfusion was associated with the development of ALI/ARDS (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.24 to 3.75). Among those patients receiving individual blood products, ALI/ARDS was more likely to develop in patients who received FFP transfusions (OR, 2.48; 95% CI, 1.29 to 4.74) and platelet transfusions (OR, 3.89; 95% CI, 1.36 to 11.52) than in those who received only RBC transfusions (OR, 1.39; 95% CI, 0.79 to 2.43). Conclusion: Transfusion is associated with an increased risk of the development of ALI/ARDS in critically ill medical patients. The risk is higher with transfusions of plasma-rich blood products, FFP, and platelets, than with RBCs.

LanguageEnglish (US)
Pages1308-1314
Number of pages7
JournalChest
Volume131
Issue number5
DOIs
StatePublished - May 2007

Fingerprint

Platelet Transfusion
Acute Lung Injury
Critical Illness
Odds Ratio
Confidence Intervals
Blood Transfusion
Cohort Studies
Blood Platelets
Multivariate Analysis
Retrospective Studies
Health

Keywords

  • Cohort study
  • Fresh-frozen plasma
  • Platelets
  • Pulmonary edema
  • Risk factor
  • Transfusion-related acute lung injury

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. / Khan, Hasrat; Belsher, Jon; Yilmaz, Murat; Afessa, Bekele; Winters, Jeffrey L.; Moore, S. Breanndan; Huhmayr, Rolf D.; Gajic, Ognjen.

In: Chest, Vol. 131, No. 5, 05.2007, p. 1308-1314.

Research output: Research - peer-reviewArticle

Khan H, Belsher J, Yilmaz M, Afessa B, Winters JL, Moore SB et al. Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. Chest. 2007 May;131(5):1308-1314. Available from, DOI: 10.1378/chest.06-3048
Khan, Hasrat ; Belsher, Jon ; Yilmaz, Murat ; Afessa, Bekele ; Winters, Jeffrey L. ; Moore, S. Breanndan ; Huhmayr, Rolf D. ; Gajic, Ognjen. / Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. In: Chest. 2007 ; Vol. 131, No. 5. pp. 1308-1314
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abstract = "Background: Transfusion has long been identified as a risk factor for acute lung injury (ALI)/ARDS. No study has formally evaluated the transfusion of specific blood products as a risk factor for ALI/ARDS in critically ill medical patients. Method: In this single-center retrospective cohort study, 841 consecutive critically ill patients were studied for the development of ALI/ARDS. Patients who received blood product transfusions were compared with those who did not, in univariate and multivariate propensity analyses. Results: Two hundred ninety-eight patients (35%) received blood transfusions. Transfused patients were older (mean [± SD] age, 67 ± 17 years vs 62 ± 19 years; p < 0.001) and had higher acute physiologic and chronic health evaluation (APACHE) III scores (74 ± 32 vs 58 ± 23; p < 0.001) than those who had not received transfusions. ALI/ARDS developed more commonly (25% vs 18%; p = 0.025) in patients exposed to transfusion. Seventeen patients received massive MBC transfusions (ie, > 10 U of blood transfused within 24 h), of whom 13 also received fresh-frozen plasma (FFP) and 11 received platelet transfusions. When adjusted for the probability of transfusion and other ALI/ARDS risk factors, any transfusion was associated with the development of ALI/ARDS (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.24 to 3.75). Among those patients receiving individual blood products, ALI/ARDS was more likely to develop in patients who received FFP transfusions (OR, 2.48; 95% CI, 1.29 to 4.74) and platelet transfusions (OR, 3.89; 95% CI, 1.36 to 11.52) than in those who received only RBC transfusions (OR, 1.39; 95% CI, 0.79 to 2.43). Conclusion: Transfusion is associated with an increased risk of the development of ALI/ARDS in critically ill medical patients. The risk is higher with transfusions of plasma-rich blood products, FFP, and platelets, than with RBCs.",
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T1 - Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients

AU - Khan,Hasrat

AU - Belsher,Jon

AU - Yilmaz,Murat

AU - Afessa,Bekele

AU - Winters,Jeffrey L.

AU - Moore,S. Breanndan

AU - Huhmayr,Rolf D.

AU - Gajic,Ognjen

PY - 2007/5

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N2 - Background: Transfusion has long been identified as a risk factor for acute lung injury (ALI)/ARDS. No study has formally evaluated the transfusion of specific blood products as a risk factor for ALI/ARDS in critically ill medical patients. Method: In this single-center retrospective cohort study, 841 consecutive critically ill patients were studied for the development of ALI/ARDS. Patients who received blood product transfusions were compared with those who did not, in univariate and multivariate propensity analyses. Results: Two hundred ninety-eight patients (35%) received blood transfusions. Transfused patients were older (mean [± SD] age, 67 ± 17 years vs 62 ± 19 years; p < 0.001) and had higher acute physiologic and chronic health evaluation (APACHE) III scores (74 ± 32 vs 58 ± 23; p < 0.001) than those who had not received transfusions. ALI/ARDS developed more commonly (25% vs 18%; p = 0.025) in patients exposed to transfusion. Seventeen patients received massive MBC transfusions (ie, > 10 U of blood transfused within 24 h), of whom 13 also received fresh-frozen plasma (FFP) and 11 received platelet transfusions. When adjusted for the probability of transfusion and other ALI/ARDS risk factors, any transfusion was associated with the development of ALI/ARDS (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.24 to 3.75). Among those patients receiving individual blood products, ALI/ARDS was more likely to develop in patients who received FFP transfusions (OR, 2.48; 95% CI, 1.29 to 4.74) and platelet transfusions (OR, 3.89; 95% CI, 1.36 to 11.52) than in those who received only RBC transfusions (OR, 1.39; 95% CI, 0.79 to 2.43). Conclusion: Transfusion is associated with an increased risk of the development of ALI/ARDS in critically ill medical patients. The risk is higher with transfusions of plasma-rich blood products, FFP, and platelets, than with RBCs.

AB - Background: Transfusion has long been identified as a risk factor for acute lung injury (ALI)/ARDS. No study has formally evaluated the transfusion of specific blood products as a risk factor for ALI/ARDS in critically ill medical patients. Method: In this single-center retrospective cohort study, 841 consecutive critically ill patients were studied for the development of ALI/ARDS. Patients who received blood product transfusions were compared with those who did not, in univariate and multivariate propensity analyses. Results: Two hundred ninety-eight patients (35%) received blood transfusions. Transfused patients were older (mean [± SD] age, 67 ± 17 years vs 62 ± 19 years; p < 0.001) and had higher acute physiologic and chronic health evaluation (APACHE) III scores (74 ± 32 vs 58 ± 23; p < 0.001) than those who had not received transfusions. ALI/ARDS developed more commonly (25% vs 18%; p = 0.025) in patients exposed to transfusion. Seventeen patients received massive MBC transfusions (ie, > 10 U of blood transfused within 24 h), of whom 13 also received fresh-frozen plasma (FFP) and 11 received platelet transfusions. When adjusted for the probability of transfusion and other ALI/ARDS risk factors, any transfusion was associated with the development of ALI/ARDS (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.24 to 3.75). Among those patients receiving individual blood products, ALI/ARDS was more likely to develop in patients who received FFP transfusions (OR, 2.48; 95% CI, 1.29 to 4.74) and platelet transfusions (OR, 3.89; 95% CI, 1.36 to 11.52) than in those who received only RBC transfusions (OR, 1.39; 95% CI, 0.79 to 2.43). Conclusion: Transfusion is associated with an increased risk of the development of ALI/ARDS in critically ill medical patients. The risk is higher with transfusions of plasma-rich blood products, FFP, and platelets, than with RBCs.

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KW - Fresh-frozen plasma

KW - Platelets

KW - Pulmonary edema

KW - Risk factor

KW - Transfusion-related acute lung injury

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