Numerous studies demonstrate that RBC transfusions are associated with complications in critically ill patients, including volume overload, acute lung injury, hemolytic reactions, increased risk of infection, multiple organ dysfunction, and death [ 3- 6].
At such high exposure concentrations, it would be reasonable to expect that the number of particles and short fibers present in the exposure would be sufficient to overload the lung through impairment of macrophage function.
In terms of volume control, patients were either ultrafiltrated because of volume overload in lung failure in the first 24 hours (four patients, -645 to −3,345 ml/24 hours) or received volume replacement as part of hypertensive shock therapy (six patients, 180 to 2,945 ml/24 hours).
In the ICU, diagnosing pneumonia is even more difficult because of technical challenges related to interpreting portable CXRs in supine patients with catheters, ventilators, devices, or competing conditions that can mimic pneumonia (e.g., fluid overload, atelectasis, lung hypo-inflation) [ 4, 5].
Moreover, even if lung overload has indeed happened, previous studies have shown that overload seems also to occur in humans with heavy dust lung burdens, as for example coal workers (see e.g. [ 39]).
The lymphatic pulmonary draining system allows this draining of water and solutes, removing the excess fluid and avoiding fluid overload in the lung.
An earlier model published in 2011 to surpass and replace the traditional Morrow approach focused on kinetic lung overload to simulate the pulmonary fate of inhaled micron-sized PSLT in rats.
In the ERC guidelines for Advanced Life Support [51], it is recommended to check blood pressure and look for signs of lung overload 10 min after fluid challenge to decide whether to continue fluid administration.
This database was used to predict the outcome of a 2-year chronic inhalation study with a focus on the no observed adverse effect level (NOAEL) and range of conditions causing kinetic lung overload up to and beyond the maximum tolerated dose (MTD).
The original studies data used for the purposes of the present study do not provide evidence of significant lung overload.
According to our calculation, volumetric lung overload can only be assumed after 4 weeks exposure to 25 mg/m.
