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What is Transfusion-Related Acute Lung Injury (TRALI) clinical symptoms are in force within how many hours after transfusion? and explain in detail?
(C) 6 Hrs[?]Transfusion-Related Acute Lung Injury (TRALI) - Syndrome characterized by acute respiratory distress following transfusion.Clinical Symptoms:Clinically symptoms & signs appear 1-2 hours after transfusion & are in force within 6 hours.Typically are in force within 6 hours of transfusion.Rapid onset of dyspnea, fluid in the endotracheal tube, tachypnea & severe hypoxia.Associated fever, cyanosis, & hypotension.Clinical examination:Reveals Respiratory Distress.Pulmonary Crackles may be present with no signs of CHF or volume overload.During anaesthesia:A persistent decrease in blood oxygen saturation can be the presenting sign.CXR - Evidence of bilateral pulmonary edema unrelated to CHF (Non-Cardiogenic Pulmonary edema).Bilateral patchy infiltrates rapidly progressing to complete "white out" indistinguishable from Acute Respiratory Distress Syndrome (ARDS).Transfusion-Related Acute Lung Injury (TRALI):Transfusion related noncardiogenic pulmonary edema.Differential diagnosis:Circulatory overload (TACO)Allergic/AnaphylacticBacterialAcute hemolytic reactionTransfusion Related Acute Lung Injury (TRALI):Life-threatening emergencyOccur during or up to 6 hours following transfusion.Incidence: 1:5,000-1:150,000Pathophysiology:HLA antibodies react with antigens on recipient granulocytes. Triggers an inflammatory response in the pulmonary vasculature.Non-cardiogenic pulmonary edema resulting from immune reactivity of certain leukocyte antibodies.Presentation:Pulmonary edema, trachypnea, tachycardia - Hypotension, frothy pink sputum and/or fever.Treatment:There is no specific therapy.Stopping the transfusion.Instituting critical care supportive measures.Supportive (monitor, airway, hemodynamics)No LasixRemember:All blood components, especially FFP are implicated as causative factors.TRALI remains one of the top 3 most common causes of transfusion related deaths.