Transfusion related acute lung injury (TRALI): When and how much to transfuse?

In a patient with reduced blood profile (reduced platelet count , decreased haemoglobin, reduced clotting factor or dearranged PT INR), it is a common practice to transfuse the patients with Blood products. Clinicians normally overdo the transfusion and neglect the negative outcome of transfusion reactions, which can be life threatning and very difficult to manage..Here we are presenting a case of thrombocytopenia who was transfused with RDP’S (random donar platelet) and later developed TRALI,a potentially fatal complication of blood product transfusion in which a patient develops rapid onset lung injury resulting in noncardiogenic pulmonary edema due to activation of immune cells in the lungs. He was further managed with mechanical ventilation and symptomatic treatment. One should exercise restrain while transfusing and transfuse only when there is a definitive indication and always watch the patient for development of respiratory distress due to TRALI. Despite aggressive support, mortality of more than 12% are reported once TRALI is diagnosed. The risk and benefit of all blood products should be assessed before transfusion.