Is Respiratory Failure a Consequence of Blood Transfusion?

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Abstract
Pulmonary entrapment of microaggregates, platelets and white cells in stored blood may contribute to lung function abnormalities. Washing of red cells removes these potentially damaging elements. This prospective, randomized, double-blind study compares the pulmonary function of patients undergoing abdominal aortic aneurysmectomy who received either washed or unwashed red cell concentrates. Both groups received equivalent volumes of blood, albumin and balanced salt solution during surgery. Postoperatively, no differences were observed in the physiologic shunt, .ovrhdot.QS/.ovrhdot.QT [shunt fraction], pulmonary artery pressure, pulmonary vascular resistance or effective dynamic compliance. The cardiac index at equivalent left ventricular filling pressures was the same. Apparently microaggregates or other formed elements in stored blood do not lead to compromised pulmonary function.