Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Vincent and colleagues1 found that patients in the intensive care unit
(ICU) who received transfusions were also at higher risk of mortality, and
that this difference persisted even after accounting for differing degrees
of organ dysfunction. Neither the authors nor Drs Hébert and Fergusson2 in the accompanying Editorial discuss transfusion-related
acute lung injury (TRALI) as an explanation for the increased mortality among
those who received transfusions. The true incidence of TRALI is unknown, but
it is considered to be one of the most common but most underdiagnosed adverse
effects of transfusion, particularly in its milder presentations.3 We believe that future research on the clinical
consequences of blood transfusion should consider this important and, until
recently, overlooked complication of blood transfusion.
Karkouti K, Beattie WS, Wijeysundera DN, McCluskey SA. Blood Transfusions and Mortality Among Critically Ill Patients. JAMA. 2003;289(10):1242-1243. doi:10.1001/jama.289.10.1242-a