<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-1249</journal-id>
<journal-title><![CDATA[Archivos de Pediatría del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Pediatr. Urug.]]></abbrev-journal-title>
<issn>1688-1249</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Uruguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-12492018000500264</article-id>
<article-id pub-id-type="doi">10.31134/ap.89.4.6</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[TRALI neonatal. A propósito de un caso clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[TRALI in newborns. Clinical case report]]></article-title>
<article-title xml:lang="pt"><![CDATA[A TRALI em recém-nascidos. Relato de caso clínico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[Deborah]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silvera]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Borbonet]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,UDELAR CHPR Cátedra Neonatología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,UDELAR CHPR Cátedra Neonatología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,UDELAR CHPR Neonatología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<volume>89</volume>
<numero>4</numero>
<fpage>264</fpage>
<lpage>270</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-12492018000500264&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-12492018000500264&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-12492018000500264&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: Los recién nacidos, sobre todo los pretérminos, constituyen uno de los grupos que reciben más hemoderivados. Si bien se han disminuido los riesgos asociados a las transfusiones, aun así pueden presentarse complicaciones1,2. TRALI (Tranfusion Related Acute Lung Injury; en español: lesión pulmonar aguda asociada a transfusión) es una complicación poco frecuente pero potencialmente grave. Reconocida inicialmente en adultos, posteriormente se describieron casos en niños. En neonatos solamente existe un caso confirmado y publicado a nivel internacional. La incidencia real es incierta, dado el poco conocimiento de la patología y el subreporte. TRALI resultaría de un daño del endotelio vascular pulmonar, causando edema pulmonar y subsecuentemente hipoxemia. El tratamiento es de sostén3. La prevención se basa principalmente en la revisión permanente de las indicaciones de transfusión de hemoderivados y en la comunicación fluida con el equipo de hemoterapia para su diagnóstico oportuno. Se describe el caso clínico de un recién nacido prematuro que durante una transfusión de concentrado de glóbulos rojos presentó hipoxemia con necesidad de asistencia ventilatoria mecánica, alteraciones hemodinámicas y fiebre. Se descartaron procesos infecciosos. La radiografía de tórax mostró infiltrados compatibles con edema pulmonar. Se descartó la falla cardíaca. El tratamiento realizado fue de sostén de las funciones vitales. La evolución fue favorable en el correr de 72 horas. Se comunicó el caso al servicio de hemoterapia. A fin de prevenir transfusiones innecesarias es importante que cada servicio revise periódicamente sus guías de transfusión de hemoderivados.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary: Newborns, especially preterm newborns, are one of the age groups that receive the most hemoderivatives. Although the progress made in the field of hemotherapy have made it possible to reduce the risks associated with transfusions, in some cases there are still complications1,2. TRALI (transfusion related acute lung injury) is a rare but potentially serious complication. It was initially detected in adults, though cases were later described in children. In newborns, only one case has been confirmed and published globally. The actual incidence is uncertain, given the insufficient knowledge of the pathology and the fact that findings have been under reported. TRALI results from pulmonary vascular endothelial damage and causes pulmonary edema and subsequent hypoxemia. Treatment is observed with supportive treatment3. Prevention is mainly based on the permanent review of the hemoderivatives' transfusion directives and on the fluent communication among members of the hemotherapy medical team in order to ensure a timely diagnosis. The clinical case described below is that of a preterm newborn who, during a transfusion of red blood cell concentrate, showed hypoxemia, hemodynamic alterations and fever and required mechanical ventilatory support. Infectious processes were ruled out. Chest X-Rays showed infiltrates compatible with pulmonary edema. Heart failure was ruled out. The treatment was performed to support vital functions. The evolution was favorable in the course of 72 hours. The case was reported to the Hemotherapy Service. Blood component transfusion guidelines should be regularly reviewed in order to prevent the performance of unnecessary transfusions.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: Os recém-nascidos, especialmente os prematuros, são um dos grupos que recebem maior quantidade de hemoderivados. Embora os riscos associados tenham diminuído com o tempo, as transfusões ainda podem trazer complicações1,2. A TRALI (lesão pulmonar aguda relacionada à transfusão) é uma complicação rara, mas potencialmente grave. Inicialmente reconhecida em adultos, os casos foram posteriormente descritos em crianças. Em neonatos, há apenas um caso confirmado e publicado a nível internacional. A incidência real é incerta, dado que existe pouco conhecimento da patologia e é pouco relatada. A TRALI é provocada por danos no endotélio vascular pulmonar e causa edema pulmonar e subsequentemente hipoxemia. O tratamento é de suporte3. A prevenção baseia-se principalmente na revisão permanente das indicações de transfusão de hemoderivados e na comunicação fluida com a equipe de hemoterapia para o diagnóstico oportuno. Descrevemos o caso clínico de um recém-nascido prematuro que apresentou hipoxemia durante transfusão de concentrado de hemácias com necessidade de ventilação mecânica, alterações hemodinâmicas e febre. Descartamos processos infecciosos. A radiografia de tórax mostrou infiltrados compatíveis com edema pulmonar. Descartamos insuficiência cardíaca. Realizamos tratamento de suporte de funções vitais. A evolução foi favorável durante 72 horas. O caso foi relatado ao serviço de Hemoterapia. Para evitar transfusões desnecessárias, é importante que cada serviço revise periodicamente as diretrizes de transfusão de hemoderivados.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Lesión pulmonar aguda relacionada con la transfusión]]></kwd>
<kwd lng="es"><![CDATA[Reacción a la transfusión. Recién nacido prematuro]]></kwd>
<kwd lng="en"><![CDATA[Transfusion-related acute lung injury]]></kwd>
<kwd lng="en"><![CDATA[Transfusion reaction]]></kwd>
<kwd lng="en"><![CDATA[Premature infant]]></kwd>
<kwd lng="pt"><![CDATA[Lesão pulmonar aguda relacionada à transfusão]]></kwd>
<kwd lng="pt"><![CDATA[Reação transfusional]]></kwd>
<kwd lng="pt"><![CDATA[Recém-nascido prematuro]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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