Massive transfusion in traumatized patient with pulmonary contusion: case report

Abstract

Introduction: We can often associate pulmonary contusion with polytrauma patients and a significant cause of acute lung injury. More severe cases can trigger Acute Respiratory Distress Syndrome (ARDS), related to expressive morbidity and mortality. Besides, it is necessary to activate the massive transfusion protocol. We can associate transfusion with the emergence of acute lung injury, either by inflammatory immune mechanisms, such as transfusion-associated acute lung injury, and mechanisms linked to the innate response, either by excessive volume replacement or sepsis. Patients who have pulmonary contusion and require massive transfusion have an essential combination of elements that can induce inflammatory lung injury, representing higher morbidity and mortality. Objective: To alert the need to activate Massive Transfusion Protocol in patients with pulmonary contusion and list its likely consequences and care taken in these cases. Case Report: Description of a patient's issue with pulmonary contusion and Acute Respiratory Distress Syndrome, seen in an emergency service at the Base Hospital of São José do Rio Preto. Conclusion: Considering the benefits and harms regarding blood transfusion and massive transfusion, there is a tendency for its routine use in emergency services supported by well-established protocols. However, further studies are necessary to reduce transfusion-related complications.