BACKGROUND: Transfusion-associated circulatory overload (TACO) can be difficult to diagnose and distinguish from transfusion-related acute lung injury (TRALI), but is a relatively common complication that occurs when increases in blood volume overwhelm the cardiovascular system. Brain natriuretic peptide (BNP) has been shown to be a functional marker for TACO. N-terminal pro-brain natriuretic peptide (NT-proBNP) is another marker that could be more helpful than BNP since it has a longer half-life in circulation and is also much more stable in laboratory samples. In this study, whether NT-proBNP is a useful diagnostic marker for TACO was evaluated. STUDY DESIGN AND METHODS: Forty patients were enrolled into a case-control study (16 patients with TACO and 24 control patients) and had pre- and posttransfusion NT-proBNP concentrations evaluated from submitted type-and-screen blood samples. RESULTS: The sensitivity of elevated posttransfusion NT-proBNP to diagnose TACO was 93.8 percent, the specificity was 83.8 percent, and the accuracy was 87.5 percent. Elevated posttransfusion NT-proBNP is the only independent variable for the diagnosis of TACO based on multivariate logistic regression. CONCLUSION: NT-proBNP is both a sensitive and a specific marker for TACO and can be helpful in confirming transfusion associated fluid overload. This study also demonstrates that many patients who experience TACO may already be in a state of excess volume. Clinicians should be aware that many asymptomatic patients have excess fluid and transfusion may cause these patients to become symptomatic.
BACKGROUND: Transfusion-associated circulatory overload (TACO) can be difficult to diagnose and distinguish from transfusion-related acute lung injury (TRALI), but is a relatively common complication that occurs when increases in blood volume overwhelm the cardiovascular system. Brain natriuretic peptide (BNP) has been shown to be a functional marker for TACO. N-terminal pro-brain natriuretic peptide (NT-proBNP) is another marker that could be more helpful than BNP since it has a longer half-life in circulation and is also much more stable in laboratory samples. In this study, whether NT-proBNP is a useful diagnostic marker for TACO was evaluated. STUDY DESIGN AND METHODS: Forty patients were enrolled into a case-control study (16 patients with TACO and 24 control patients) and had pre- and posttransfusion NT-proBNP concentrations evaluated from submitted type-and-screen blood samples. RESULTS: The sensitivity of elevated posttransfusion NT-proBNP to diagnose TACO was 93.8 percent, the specificity was 83.8 percent, and the accuracy was 87.5 percent. Elevated posttransfusion NT-proBNP is the only independent variable for the diagnosis of TACO based on multivariate logistic regression. CONCLUSION:NT-proBNP is both a sensitive and a specific marker for TACO and can be helpful in confirming transfusion associated fluid overload. This study also demonstrates that many patients who experience TACO may already be in a state of excess volume. Clinicians should be aware that many asymptomatic patients have excess fluid and transfusion may cause these patients to become symptomatic.
Authors: Christoph Bührer; Ömer Erdeve; Anton van Kaam; Angelika Berger; Evelyn Lechner; Benjamin Bar-Oz; Karel Allegaert; Tom Stiris; İstemi Han Çelik; Janet Berrington Journal: Pediatr Res Date: 2017-08-16 Impact factor: 3.756
Authors: Nareg H Roubinian; Mark R Looney; Sheila Keating; Daryl J Kor; Clifford A Lowell; Ognjen Gajic; Rolf Hubmayr; Michael Gropper; Monique Koenigsberg; Gregory A Wilson; Michael A Matthay; Pearl Toy; Edward L Murphy Journal: Transfusion Date: 2017-05-03 Impact factor: 3.157
Authors: Edward L Murphy; Nicholas Kwaan; Mark R Looney; Ognjen Gajic; Rolf D Hubmayr; Michael A Gropper; Monique Koenigsberg; Greg Wilson; Michael Matthay; Peter Bacchetti; Pearl Toy Journal: Am J Med Date: 2013-01-26 Impact factor: 4.965