Pulmonary transfusion reactions Quiz: Ace Your Exams

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A 67-year-old man with a history of chronic anemia is brought to the emergency department for evaluation of shortness of breath and chest tightness that developed 30 minutes after receiving a packed red blood cell transfusion. His past medical history includes hypertension and chronic kidney disease stage 3. His regular medications include lisinopril and amlodipine. On examination, temperature is 37.0°C (98.6°F), heart rate is 110/min, blood pressure is 160/95 mmHg, respiratory rate is 22/min, and oxygen saturation is 90% on room air. Physical examination reveals bilateral rales at the lung bases and distended jugular veins. Electrocardiogram (ECG) is significant for sinus tachycardia and voltage criteria for left ventricular hypertrophy. Laboratory evaluation reveals a hemoglobin level of 10.2 g/dL, creatinine of 3.2 mg/dL, and elevated B-type natriuretic peptide (BNP). Chest X-ray shows diffuse bilateral infiltrates. An echocardiogram is pending. Which of the following is the best next step in management?  

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