TRALI

The classic TRALI syndrome is an uncommon condition characterized by the abrupt onset of respiratory failure within hours of the transfusion of a blood product. 












It is usually caused by anti-leukocyte antibodies, resolves rapidly, and has a low mortality. 
A single unit of packed cells or blood component product is usually implicated in initiating this syndrome.


 It has, however, recently been recognized that the transfusion of blood products in critically ill or injured patients increases the risk (odds ratio 2.13; 95% confidence interval 1.75-2.52) for the development of the ALI 6-72 hours after the transfusion.


 This "delayed TRALI syndrome" is common, occurring in up to 25% of critically ill patients receiving a blood transfusion, and is associated with a mortality of up to 40%. 


While the delayed TRALI syndrome can develop after the transfusion of a single unit, the risk increases as the number of transfused blood products increase. 


The management of both the classic and delayed TRALI syndromes is essentially supportive.