Abstract
Transfusion-related acute lung injury (TRALI) is a subcategory of acute lung injury (ALI). As such, there are many similarities between the syndromes, both clinically and pathophysiologically. Pulmonary changes in fibrin turnover have emerged as a hallmark of ALI, thereby initiating studies investigating the potential of therapeutic interventions aimed at ameliorating this so-called pulmonary coagulopathy. Enhanced coagulation and impaired fibrinolysis are probably also important features of TRALI. In particular, platelets play an important role in mediating injury during a TRALI reaction. In this narrative review, the evidence of the role of coagulopathy and platelet activation in TRALI is discussed. Given that host risk factors for acquiring TRALI have been identified and that there is a time frame in which a preventive strategy in patients at risk for TRALI can be executed, preventive strategies are suggested. In this review, we discuss potential preventive anticoagulant interventions.
Keywords: TRALI, platelets, acetylsalicylic acid, coagulation, fibrinolysis, ALI, therapy, fibrin turnover, pulmonary coagulopathy, anticoagulant interventions
Current Pharmaceutical Design
Title:Coagulopathy as a Therapeutic Target for TRALI: Rationale and Possible Sites of Action
Volume: 18 Issue: 22
Author(s): Pieter R. Tuinman, Marcus J. Schultz and Nicole P. Juffermans
Affiliation:
Keywords: TRALI, platelets, acetylsalicylic acid, coagulation, fibrinolysis, ALI, therapy, fibrin turnover, pulmonary coagulopathy, anticoagulant interventions
Abstract: Transfusion-related acute lung injury (TRALI) is a subcategory of acute lung injury (ALI). As such, there are many similarities between the syndromes, both clinically and pathophysiologically. Pulmonary changes in fibrin turnover have emerged as a hallmark of ALI, thereby initiating studies investigating the potential of therapeutic interventions aimed at ameliorating this so-called pulmonary coagulopathy. Enhanced coagulation and impaired fibrinolysis are probably also important features of TRALI. In particular, platelets play an important role in mediating injury during a TRALI reaction. In this narrative review, the evidence of the role of coagulopathy and platelet activation in TRALI is discussed. Given that host risk factors for acquiring TRALI have been identified and that there is a time frame in which a preventive strategy in patients at risk for TRALI can be executed, preventive strategies are suggested. In this review, we discuss potential preventive anticoagulant interventions.
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Cite this article as:
R. Tuinman Pieter, J. Schultz Marcus and P. Juffermans Nicole, Coagulopathy as a Therapeutic Target for TRALI: Rationale and Possible Sites of Action, Current Pharmaceutical Design 2012; 18 (22) . https://dx.doi.org/10.2174/1381612811209023267
DOI https://dx.doi.org/10.2174/1381612811209023267 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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