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.
BACKGROUND: Transfusion-associated circulatory overload (TACO) is a frequent complication of blood transfusion. Investigations identifying risk factors for TACO in critically illpatients 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; Marija Kojicic; Martin K Reriani; Evans R Fernández Pérez; Lokendra Thakur; Rahul Kashyap; Camille M Van Buskirk; Ognjen Gajic Journal: Chest Date: 2009-10-16 Impact factor: 9.410
Authors: Daryl J Kor; Rahul Kashyap; Richard B Weiskopf; Gregory A Wilson; Camille M van Buskirk; Jeffrey L Winters; Michael Malinchoc; Rolf D Hubmayr; Ognjen Gajic Journal: Am J Respir Crit Care Med Date: 2012-01-26 Impact factor: 21.405
Authors: Che Ngufor; Matthew A Warner; Dennis H Murphree; Hongfang Liu; Rickey Carter; Curtis B Storlie; Daryl J Kor Journal: AMIA Annu Symp Proc Date: 2018-04-16
Authors: Nareg H Roubinian; Jeanne E Hendrickson; Darrell J Triulzi; Jerome L Gottschall; Michael Michalkiewicz; Dhuly Chowdhury; Daryl J Kor; Mark R Looney; Michael A Matthay; Steven H Kleinman; Donald Brambilla; Edward L Murphy Journal: Crit Care Med Date: 2018-04 Impact factor: 7.598
Authors: Alexander B Pine; Eun-Ju Lee; Mikkael Sekeres; David P Steensma; Daniel Zelterman; Thomas Prebet; Amy DeZern; Rami Komrokji; Mark Litzow; Selina Luger; Richard Stone; Harry P Erba; Guillermo Garcia-Manero; Alfred I Lee; Nikolai A Podoltsev; Lisa Barbarotta; Stephanie Kasberg; Jeanne E Hendrickson; Steven D Gore; Amer M Zeidan Journal: Transfusion Date: 2016-11-22 Impact factor: 3.157
Authors: Jeanne E Hendrickson; Nareg H Roubinian; Dhuly Chowdhury; Don Brambilla; Edward L Murphy; Yanyun Wu; Paul M Ness; Eric A Gehrie; Edward L Snyder; R George Hauser; Jerome L Gottschall; Steve Kleinman; Ram Kakaiya; Ronald G Strauss Journal: Transfusion Date: 2016-07-26 Impact factor: 3.157