[HSF] A TRALI case

[Ben Bidstrup]

Hal,
You have indicated in the past  your willingness to give multiple 
blood products. At what stage during  the procedure were they given? 
What was the platelet count ?

>Ben,
>   The platelet count was quite low intraop.  That's the reason I 
>gave it.  In retrospect, I wished I had not.
>Hal
>
>-----Original Message-----
>From: benjamin.bidstrup at bigpond.com
>To: OpenHeart-L at lists.hsforum.com
>Sent: Thu, 15 Mar 2007 6:41 AM
>Subject: Re: [HSF] A TRALI case
>
>
>>Mark and Prasanna,
>>  Thanks for your input. Like you, Mark, I had a very similar case after an
>>uneventful minimally invasive ASD closure and Cox-maze. The patient got
>>some platelets intraop. The postop TEE looked perfect, and he 
>>came >off easily. >However, prior to transfer to CVICU, he started 
>>emitting large amounts of
>>thin bloody fluid from ET tube. This was in spite of a normal TEE with an EF
>>of 60%. He became progressively hypoxic and ultimately died hours 
>>postop. >Even though I live in South Florida, I pushed for an 
>>autopsy. The suture
>>lines were perfect. The lungs had intense PMN infiltration consistent with a
>>severe transfusion reaction. I don't remember the 
>>pathologist >saying TRALI, but
>>I assume that's what it was.
>>Hal
>
>Why give platelets intra-operatively?
>-- Ben Bidstrup FRACS FRCSEd FEBCTS
>Consultant Cardiothoracic Surgeon
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon