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PEDIATRIC ANESTHESIA

Transfusion-Related Acute Lung Injury in an Infant During Craniofacial Surgery

Douglas G. Ririe, MD^*, Patrick E. Lantz, MD, Steven S. Glazier, MD, and Louis C. Argenta, MD

Departments of *Anesthesiology, Pathology, Neurosurgery, and Plastics and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina

Address correspondence to Douglas G. Ririe, MD, Department of Anesthesiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157–1009. Address e-mail to dririe{at}wfubmc.edu.

Transfusion-related acute lung injury (TRALI) is a potentially life-threatening, systemic, immune-mediated reaction to transfused blood product. The symptoms may be masked under general anesthesia. In this case report, we describe an infant who developed TRALI under general anesthesia for craniofacial surgery. The difficulty with diagnosis, the pathophysiology, and the need for understanding and recognition to reduce morbidity and mortality are discussed.