輸血相關性急性肺損傷（TRALI）是發生于輸血期間或輸血后的罕見并發癥，以急性缺氧和非心源性肺水腫為特點，因死亡率高（5%~10%）而越來越受到臨床關注[1]，據2004年美國食品藥品管理局（FDA）的數據，TRALI為輸血相關性死亡的首要因素[2]。根據文獻資料，輸注血制品、含血漿制品、新鮮冰凍血漿（FFP）和血小板的TRALI發生率分別約為1/5 000[3]，1/2 000[4]，1/7 900[5]和1/432[6]。據報道，所有血制品（除白蛋白外）均可引起TRALI[7]，甚至有作者懷疑大劑量給予白細胞介素-2（IL-2）也可能導致TRALI[8]。目前，我國有關TRALI的報道較少，僅有個別死亡案例報道[9，10]，而相關的研究報道很少，這可能與我們尚未認識到TRALI的危險性，以及對其的診斷率較低有關。
Objectives To explore the efficacy of humidified and heated high flow oxygen therapy for the critically ill patients in intensive care unit (ICU) after extubation. Methods From January 2014 to December 2016, 487 patients were enrolled. Patients were allocated to two treatment groups randomly, which were humidified and heated high flow oxygen therapy group (236 patients, HFM group, aged 55.3±21.1 years old) and routine oxygen therapy group (251 patients, TO group, aged 58.4±19.3 years old). Blood oxygen saturation, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), fraction of inspired oxygen (FiO2), respiratory frequency, incidence rate of reintubation, ventilator-free days, ICU length of stay, and hospital stay were assessed and compared between the HFM group and the TO group. Results The hospital stay was similar in two groups. There were more ventilator-free days in the HFM group (P<0.05), fewer patients required reintubation (4.2%vs. 10.4%, P<0.05) and less ICU length of stay [(10.5±6.1) dvs. (14.3±8.5) d, P<0.05]. PaO2/FiO2 of the HFM group were better than the TO group after extubation at 2 h, 4 h, 8 h, 24 h, and 48 h (P<0.05). There were no statistically significant differences in respiratory frequency and PaCO2. Conclusions Humidified and heated high flow oxygen therapy can supply a better oxygenation for patients after extubation in ICU. It could be a common therapy in ICU for the critically patients after extubation.