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The page below is a sample from the LabCE course Adverse Effects of Fresh Frozen Plasma Transfusion: TRALI, TACO and Allergic Reactions. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Transfusion-Related Acute Lung Injury (TRALI)

TRALI is an adverse reaction most often associated with the transfusion of plasma. TRALI has been defined as the onset of acute lung injury with hypoxemia (PaO2/FiO2< 300 or SpO2 <90% on room air) within 6 hours of transfusion in a patient with no previous risk of lung injury. Symptoms include shortness of breath, severe hypoxia, fever, chills, hypotension, and radiographic evidence of new onset bilateral pulmonary edema usually presenting within 2-6 hours after transfusion. Symptoms of TRALI are similar to other adverse reactions to plasma transfusion such as TACO and allergic reactions (which will be discussed later in the course); thus, differential diagnosis may be difficult. Mild cases of TRALI may be difficult to recognize and therefore the incidence of TRALI may be under-reported. TRALI symptoms often subside within 24-48 hours but the mortality rate is high (approximately 5-25% of cases). It is the most common cause of transfusion-associated mortality in the U.S.