Acute Lung Injury

A syndrome of lung-specific damage (without contribution from cardiac causes), thought to be caused by inflammatory processes. Acute Lung Injury (ALI) is defined (according to a 1994 consensus conference) as the acute onset of hypoxemia with chest x-ray evidence of pulmonary edema and WITHOUT evidence of left atrial hypertension (wedge pressure less than 18, if available). ALI is important to us in transfusion medicine as part of a specific transfusion complication known as “Transfusion-related Acute Lung Injury (TRALI).” TRALI was defined in 1995 by a consensus group convened by the National Heart, Lung, and Blood Institute (NHLBI) as “acute lung injury occurring during or within six hours of transfusion, with a clear temporal relationship to the transfusion” (Critical Care Med. 2005 Apr;33(4):721-6). In addition to transfusion, however, other things are known to be associated with ALI, including sepsis, aspiration of gastric contents, DIC, and near-drowning.

I have much more information on TRALI in several different podcasts, including episodes 089 and 069.

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