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2008, Número 4

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Med Crit 2008; 22 (4)


Lesión pulmonar aguda secundaria a transfusión

Carrillo ER, Carrillo CLD

Idioma: Español
Referencias bibliográficas: 43
Paginas: 241-247
Archivo PDF: 68.17 Kb.


RESUMEN

La lesión pulmonar aguda secundaria a transfusión (LPAAT) se caracteriza por el desarrollo de insuficiencia respiratoria aguda y edema pulmonar en las primeras 6 horas después de la transfusión, con un amplio espectro clínico de presentación. Los casos reportados de LPAAT son la punta del iceberg de la realidad, pues habitualmente es infradiagnosticada. Debe diferenciarse de la sobrecarga circulatoria asociada a transfusión. En su forma fulminante es indistinguible de la lesión alveolar aguda secundaria a diferente etiología. Su gravedad depende de la susceptibilidad del enfermo y de la naturaleza de los disparadores contenidos en los productos transfundidos y que pueden ser granulocitos activados y partículas lipídicas biológicamente activas. La LPAAT no inmune tiene habitualmente una evolución benigna, la variante inmune es más grave y puede llegar a ser fatal; afortunadamente su incidencia es baja (1 en 5,000 transfusiones). La principal estrategia para su abordaje es la prevención mediante la selección de los donadores de productos sanguíneos, en especial plasma fresco y concentrados plaquetarios y el uso racional de productos sanguíneos.


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