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Blood microaggregates and ultrafilters

M D Rosario, E W Rumsey, G Arakaki

The Journal of Trauma

|July 1, 1978

Summary

This study on post-traumatic pulmonary insufficiency (PTPI) found microemboli in stored blood have low clinical significance. Modern management has improved PTPI outcomes, with sepsis being a key factor in persistent respiratory failure.

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Area of Science:

Medical Research
Pulmonary Medicine
Trauma Surgery

Background:

Post-traumatic pulmonary insufficiency (PTPI) has historically been a severe complication.
Advances in trauma care and blood product management may have altered PTPI's clinical course.

Purpose of the Study:

To investigate the role of microaggregates in stored blood in PTPI.
To evaluate current management strategies for PTPI.
To identify factors contributing to persistent respiratory failure in trauma patients.

Main Methods:

Animal studies on hemodynamic and ventilatory changes after resuscitation.
Post-mortem analysis of lung microemboli in patients receiving blood transfusions.
Retrospective review of respiratory complications in 153 multiple-trauma patients.

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Main Results:

No significant pulmonary changes were observed in baboons resuscitated with fresh or stored blood.
Microemboli were found in the lungs of approximately two-thirds of patients receiving >5 units of blood within 24 hours of death.
Persistent respiratory failure in trauma patients is now rare, occurring late after injury, and primarily in septic patients.

Conclusions:

The clinical significance of microaggregates in stored blood appears to be low.
Ultrafiltration of blood products is only beneficial if it does not hinder transfusion rates or increase costs.
Sepsis is a critical factor in the development of late-onset respiratory failure in trauma patients.