• Alimorad G Djalali, Kimberly A Moore, and Edward Kelly.
• Department of Anesthesiology, Perioperative Pain Medicine and Intensive Care, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. adjalali@partners.org
• Resuscitation. 2005 Aug 1;66(2):225-30.

ObjectiveTo report a patient with a large gastrointestinal stromal tumor (GIST) who received multiple blood transfusions intraoperatively and developed a transfusion-related acute lung injury (TRALI).DesignCase report.SettingIntensive care unit of a tertiary care hospital. PATIENT AND HISTORY: A 58-year-old man with GIST metastatic to the right lobe of the liver, treated with tyrosine kinase inhibitors, underwent a right hepatectomy requiring multiple transfusions. Prior to abdominal closure, he developed copious pulmonary secretions, hypoxemia, and hypotension. Chest radiograph revealed diffuse bilateral infiltrates.InterventionVolume resuscitation, vasopressors, high PEEP mechanical ventilation, paralysis, nitric oxide, steroids, rapid albumin infusion.Measurements And Main ResultsExtensive noncardiogenic pulmonary edema. After unsuccessful fluid resuscitation with crystalloid fluid, the patient's condition improved rapidly with human albumin boluses. No neurological deficit was detected despite prolonged hypoxemia. Acute renal failure required dialysis but with subsequent recovery. Patient was discharged home on postoperative day 19.ConclusionRapid infusion of albumin might be a rescue option in cases of severe TRALI with extensive pulmonary capillary leak during the acute phase.

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