| Incidence and transfusion risk factors for transfusion-associated circulatory overload among medical intensive care unit patients. | |
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MedLine Citation:
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PMID: 20723173 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Guangxi Li; Sonal Rachmale; Marija Kojicic; Khurram Shahjehan; Michael Malinchoc; Daryl J Kor; Ognjen Gajic |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-08-17 |
Journal Detail:
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Title: Transfusion Volume: 51 ISSN: 1537-2995 ISO Abbreviation: Transfusion Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-02-11 Completed Date: 2011-04-04 Revised Date: 2012-02-02 |
Medline Journal Info:
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Nlm Unique ID: 0417360 Medline TA: Transfusion Country: United States |
Other Details:
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Languages: eng Pagination: 338-43 Citation Subset: IM |
Copyright Information:
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© 2010 American Association of Blood Banks. |
Affiliation:
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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:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Lung Injury
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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:
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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:
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0/Anticoagulants |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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