ARDS is a lung disease that disrupts the normal breathing process and usually occurs in conjunction with traumatic medical conditions. “Our study showed that transfusion of PRBCs is an independent predictor of ARDS in adult trauma patients,” said lead researcher John D. Lang. “Our findings suggest that a conservative transfusion strategy that decreases PRBC exposure may be warranted to reduce the risk of ARDS in these patients.”
Blood transfusions are vital for the treatment of critically ill patients by replacing lost blood volume, correcting the body’s blood clotting ability and improving oxygen delivery. “Previous studies have suggested that a safe threshold for the number of transfused units of blood may exist,” commentated Dr. Moss, from the University of Colorado, on the study. “In this study, a dose-dependent association between the number of transfused units and the development of ARDS was exhibited.”
The study involves 14,070 patients. “Our main findings are that early PRBC transfusion of more than five units during the first 24 hours of hospital admission predicted ARDS and that each unit of PRBCs transfused early after admission increased the risk of ARDS by six percent, indicating that each unit of blood administered carries a particular risk to the patient. Exercising prudence in transfusing trauma patients should be urged”, said Lang.
The study is also the first to report an independent association between transfusion of fresh frozen plasma (as opposed to PRBCs) and the development of ARDS in trauma patients, said Moss. “While a restrictive strategy of PRBC transfusion may only decrease exposure by a few units, a restrictive strategy in the use of fresh frozen plasma has the potential to prevent large exposure to blood products.” These findings point to fresh frozen plasma as an emerging and possibly predominant risk factor for the development of transfusion-related ARDS, said Moss.
The researchers indicate that further clinical trials will be necessary before the findings can be applied to widespread practice.
MEDICA.de; Source: American Society of Anesthesiologists (ASA)