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Computer-generated Automatic Alerts of Respiratory Distress after Blood Transfusion

^a College of Medicine, University of Cincinnati, Cincinnati, OH
^b School of Pharmacy, University of California San Francisco, San Francisco, CA
^c Department of Laboratory Medicine, School of Medicine, University of California San Francisco, San Francisco, CA.

^_* Correspondence: Pearl Toy, MD, Department of Laboratory Medicine, School of Medicine, Box 0100, University of California San Francisco, San Francisco, CA 94143-0100 (Email: pearl.toy{at}ucsf.edu).

Received for publication: 06/02/07; accepted for publication: 01/16/08.

Transfusion-related acute lung injury (TRALI), the leading cause of transfusion-related death, is underreported by clinicians. For TRALI research, a clinician-independent, computerized system has been developed to detect patients with acute respiratory distress posttransfusion. A computer system generates an alert when a blood gas result indicated a PaO₂:FiO₂ ratio below 300, within twelve hours of blood issued from the blood bank for a patient. The system was prospectively compared to conventional daily rounds in intensive care units (ICUs). We found that ICU rounds detected 9 of 14 patients (64%), while the computer system detected 13 of 14 patients (93%), p = 0.125. ICU rounds took two to three hours per day, while the computer system took one to one and one-half hours per day of investigator time. In conclusion, an automatic computer alert system was more efficient, and was as effective as conventional daily ICU rounds, in detecting patients with posttransfusion acute respiratory distress.