[HSF] A TRALI case

[prasannasimha]

Hal, lot of patients have abnormal profiles immediately post CPB but do 
not need transfusions. How do you differentiate them.
Claudia - I was thinking you will take the bait.
Prasanna

Hgrmd at aol.com wrote:
> Ani,
>   A few provocative statements, I'd say!  If you think it's  uncommon for 
> abnormal coagulation profiles to cause postop bleeding, then your  experience is 
> significantly different from mine.  I can't tell you the  number of patients 
> I've seen postop with thin bloody drainage who stop bleeding  once the INR or 
> the platelet count has been corrected.
>   You are absolutely right that ECMO should have been started.   
> Unfortunately, the nurse taking care of the patient didn't notify me of the  deteriorating 
> oxygenation and hemodynamics until very late in the course.   As soon as I 
> heard what was going on, I ran back to the hospital and inserted an  IABP.  
> Twenty minutes later, the patient coded.  Having never seen or  heard of TRALI, I 
> thought that this must be some sort of cardiac  dysfunction.  In the future, 
> my index of suspicion will always be there,  and, of course, I'll institute 
> ECMO sooner than later.
> Hal
>
>
>
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