What harmful effect can occur from the rapid transfusion of packed red blood cells (PRBCs)?

Transfusion-related acute lung injury (TRALI) is a serious complication that can occur following the transfusion of packed red blood cells (PRBCs). It is characterized by acute respiratory distress and non-cardiogenic pulmonary edema that typically presents within six hours of the transfusion. TRALI is believed to result from the interaction between recipient leukocytes and donor antibodies, leading to inflammation in the lungs.

While hypothermia, transfusion-associated circulatory overload (TACO), and increased risk of infection are all potential risks associated with blood transfusions, TRALI is of particular concern due to its sudden onset and severe nature.

Hypothermia can occur if the blood products are not warmed before transfusion, TACO is linked to fluid overload affecting patients with compromised cardiac function, and the risk of infection, although present, is significantly reduced due to modern screening and testing of blood products. However, TRALI poses an immediate and critical concern for patient's respiratory status and often requires swift intervention. Understanding the mechanisms and risks of TRALI helps in providing safer transfusion practices and better patient outcomes.