Vox sanguinis
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Review
'Last-ditch' use of recombinant factor VIIa in patients with massive haemorrhage is ineffective.
The aim of this retrospective study was to assess the effect of activated recombinant factor VII (rFVIIa) on the natural history of massive transfusion episodes. ⋯ Last-ditch rFVIIa therapy in patients resistant to conventional treatment did not rescue these patients or significantly alter outcomes.
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Pulmonary complications are increasingly recognized as serous hazards of transfusion. The evidence suggests that transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are underrecognized. Both present with dyspnea but other signs and symptoms assist in determining the proper diagnosis. ⋯ Morbidity is significant with both complications and in the case of TRALI, the mortality is in the range of 6-10%. Although the clinical descriptions of both entities are well established, the clinical profile of the at-risk population for both TRALI and TACO is not well understood. Because early intervention can reduce morbidity, it is important that clinicians recognize these disorders and apply appropriate treatment.