Application of Extracorporeal Membranous Oxygenation in Trauma Patient with Possible Transfusion Related Acute Lung Injury (TRALI)

Lee,  Dae Sang; Park,  Chi Min

doi:2015.28.1.34

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Case Report

Journal of Trauma and Injury 2015;28(1):34-38.
DOI: https://doi.org/10.20408/jti.2015.28.1.34 Published online March 30, 2015.

Application of Extracorporeal Membranous Oxygenation in Trauma Patient with Possible Transfusion Related Acute Lung Injury (TRALI)

Dae Sang Lee, Chi Min Park

¹Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. dr99.park@samsung.com
²Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

수혈 관련 급성 폐손상이 동반된 외상환자에서 체외막 산화기의 적용 경험

이대상1,2, 박치민1,2

1중환자의학과, 성균관대학교 의과대학, 2외과, 성균관대학교 의과대학 삼성서울병원

Received: 25 November 2014 • Revised: 11 December 2014 • Accepted: 6 January 2015

Abstract

The case of a patient with a transfusion-related acute lung injury (TRALI) to whom extracorporeal membrane oxygenation (ECMO) had been applied is reported. A 55-year-old male injured with liver laceration (grade 3) without chest injury after car accident. He received lots of blood transfusion and underwent damage control abdominal surgery. In the immediate postoperative period, he suffered from severe hypoxia and respiratory acidosis despite of vigorous management such as 100% oxygen with mechanical ventilation, high PEEP and muscle relaxant. Finally, ECMO was applied to the patients as a last resort. Aggressive treatment with ECMO improved the oxygenation and reduced the acidosis. Unfortunately, the patient died of liver failure and infection. TRALI is a part of acute respiratory distress syndrome (ARDS). The use of ECMO for TRALI induced severe hypoxemia might be a useful option for providing time to allow the injured lung to recover.

Key Words: Adult; Blood transfusion; Extracorporeal membrane oxygenation; Respiratory distress syndrome; Trauma

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