Presentation

Ms. R.W., a 35-year-old otherwise healthy woman and a Mr. Y.K., a 65-year-old man with congestive heart failure(CHF) both receive 2 units of RBCs following surgery in the post-operative recovery room. During transfusion of the second unit of blood, both become hypoxemic and complain of dyspnea. Chest x-rays are ordered for both patients.

Questions to consider:

• What is the likely cause of this clinical picture in Ms. R.W., the previously healthy woman?
• What is the likely cause of this clinical picture in Mr. Y.K., the man with CHF?
• What is the appropriate treatment for each of these two patients?