Pulmonary Edema in the Course of a Blood Transfusion without Overloading the Circulation

¹ Department of Radiology, Peter Bent Brigham Hospital and Harvard Medical School

Three cases of transient pulmonary edema in the course of blood transfusion reactions are reported. The edema seen radiologically was presumably mainly interstitial, was accompanied by cough, fever and cyanosis, and could not be identified by physical examination. The reactions are attributed to incompatibility of undetermined nature. Hypervolemia is not considered the causative factor because of the small amount of transfused blood and lack of clinical evidence of left ventricular failure. The role of histamine release and capillary permeability are discussed as possible causative factors in the pathophysiology of the pulmonary edema. With the recent interest in postcardiotomy reactions, the study of this fleeting pulmonary edema in nonsurgical cases may shed some light upon the more complex postperfusion lung syndrome.