Document Detail


Incidence and transfusion risk factors for transfusion-associated circulatory overload among medical intensive care unit patients.
MedLine Citation:
PMID:  20723173     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Transfusion-associated circulatory overload (TACO) is a frequent complication of blood transfusion. Investigations identifying risk factors for TACO in critically ill patients are lacking.
STUDY DESIGN AND METHODS: We performed a 2-year prospective cohort study of consecutive patients receiving blood product transfusion in the medical intensive care unit (ICU) of the tertiary care institution. Patients were followed for development of transfusion-related complications. TACO was defined as acute hydrostatic pulmonary edema occurring within 6 hours of transfusion. In a nested case-control design, transfusion characteristics were compared between cases (TACO) and controls after matching by age, sex, and ICU admission diagnostic category. In a secondary analysis, patient characteristics before transfusion were compared between cases (TACO) and randomly selected controls.
RESULTS: Fifty-one of 901 (6%) transfused patients developed TACO. Compared with matched controls, TACO cases had a more positive fluid balance (1.4 L vs. 0.8 L, p = 0.003), larger amount of plasma transfused (0.4 L vs. 0.07 L, p = 0.007), and faster rate of blood component transfusion (225 mL/hr vs. 168 mL/hr, p = 0.031). In a secondary analysis comparing TACO cases and random controls, left ventricular dysfunction before transfusion (odds ratio [OR], 8.23; 95% confidence interval [CI], 3.36-21.97) and plasma ordered for the reversal of anticoagulant (OR, 4.31; 95% CI, 1.45-14.30) were significantly related to the development of TACO.
CONCLUSION: Volume of transfused plasma and the rate of transfusion were identified as transfusion-specific risk factors for TACO. Left ventricular dysfunction and fresh-frozen plasma ordered for the reversal of anticoagulant were strong predictors of TACO before the onset of transfusion.
Authors:
Guangxi Li; Sonal Rachmale; Marija Kojicic; Khurram Shahjehan; Michael Malinchoc; Daryl J Kor; Ognjen Gajic
Related Documents :
16670233 - Blood transfusions in the early years of aids in sub-saharan africa.
19664733 - International blood collection and storage: clinical use of blood products.
693083 - Prenatal diagnosis of hemoglobinopathies.
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-08-17
Journal Detail:
Title:  Transfusion     Volume:  51     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-11     Completed Date:  2011-04-04     Revised Date:  2012-02-02    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-43     Citation Subset:  IM    
Copyright Information:
© 2010 American Association of Blood Banks.
Affiliation:
Division of Pulmonary and Critical Care Medicine, Mayo Epidemiology and Translational Research in Intensive Care, Mayo Clinic, Rochester, Minnesota, USA. li.guangxi@mayo.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / epidemiology*,  etiology
Aged
Aged, 80 and over
Anticoagulants / adverse effects
Blood Transfusion / adverse effects*
Blood Volume
Cardiovascular Diseases / epidemiology
Case-Control Studies
Comorbidity
Critical Illness
Female
Humans
Incidence
Intensive Care Units*
Male
Matched-Pair Analysis
Middle Aged
Mitral Valve Insufficiency / etiology
Plasma
Prospective Studies
Pulmonary Edema / epidemiology*,  etiology
Respiratory Distress Syndrome, Adult / epidemiology,  etiology
Risk Factors
Ventricular Dysfunction, Left / etiology
Grant Support
ID/Acronym/Agency:
HL78743/HL/NHLBI NIH HHS; HL81027/HL/NHLBI NIH HHS; K23 HL078743-01A1/HL/NHLBI NIH HHS; K23 HL078743-02/HL/NHLBI NIH HHS; K23 HL078743-03/HL/NHLBI NIH HHS; K23 HL078743-04/HL/NHLBI NIH HHS; K23 HL078743-05/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Anticoagulants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Falsification or paradigm shift? Toward a revision of the common sense of transfusion.
Next Document:  A new Ser472Asn (Cab2(a+) ) polymorphism localized within the ?IIb "thigh" domain is involved in neo...