Q: Steroids and diuretics are indicated in treatment of Transfusion-related acute lung injury (TRALI)

A) True
B) False



Answer: False

So far there is no evidence that steroids are helpful in TRALI. Another mistake would be to administer diuretics. TRALI is associated with microvascular damage and not fluid overload, so diuretics are not really helpful and actually not recommended. Since the pulmonary edema in TRALI is not related to fluid overload or cardiac dysfunction, it is logical that maintenance of adequate circulating volume is more beneficial - so it may even require IV fluid. Ventilatory assistance and circulatory support are the mainstays of treatment of TRALI. Diuretic use may be detrimental and could lead to hypotension.

TRALI is essentially a clinical diagnosis but one laboratory finding may include sudden fall in serum albumin.