BACKGROUND: Monitoring of patients' vital sign values (VSVs) during hemotherapy may have an important role in the recognition and mitigation of transfusion-associated circulatory overload (TACO). Knowledge regarding VSVs and other patient characteristics in bedside-reported TACO or fluid challenge-suspected transfusion reactions (TACO/FC-STRs) is limited. STUDY DESIGN AND METHODS: We performed a retrospective observational cohort study of cases of uncomplicated red blood cell (RBC) transfusions (UCTs) and reported suspected transfusion reaction (STR) cases investigated by our hospital's transfusion medicine service (TMS) from January 1, 2005, to February 29, 2008, using data obtained from TMS consult reports and quality improvement databases examining VSVs and patient characteristics in TACO/FC-STRs. RESULTS: The frequency of TACO/FC-STRs was 0.19% per all RBC units transfused (1:530 units transfused). Both clinically and statistically (p≤0.05) significant changes were encountered in all VSVs in patients experiencing TACO/FC-STRs either at the 15-minute time interval or at the end-of-transfusion time points. Measured and derived VSVs related to the patients' blood pressure in the peritransfusion period were consistently increased. Approximately two-thirds of TACO/FC-STR patients also exhibited inflammatory related signs and symptoms at STR bedside presentation. Differences (all p≤0.050) between UCT and TACO/FC-STR cohorts were seen for patient mean weights (80 kg vs. 72 kg), mean minutes to transfusion completion (121 min vs. 83 min), and mean storage age of suspected sentinel RBC unit (22.5 days vs. 25.2 days). CONCLUSION: Trend monitoring of peritransfusion VSVs, especially blood pressures, may aid in the bedside recognition of TACO/FC-STRs. A subset of these patients may also present with febrile and/or inflammatory signs and symptoms.
BACKGROUND: Monitoring of patients' vital sign values (VSVs) during hemotherapy may have an important role in the recognition and mitigation of transfusion-associated circulatory overload (TACO). Knowledge regarding VSVs and other patient characteristics in bedside-reported TACO or fluid challenge-suspected transfusion reactions (TACO/FC-STRs) is limited. STUDY DESIGN AND METHODS: We performed a retrospective observational cohort study of cases of uncomplicated red blood cell (RBC) transfusions (UCTs) and reported suspected transfusion reaction (STR) cases investigated by our hospital's transfusion medicine service (TMS) from January 1, 2005, to February 29, 2008, using data obtained from TMS consult reports and quality improvement databases examining VSVs and patient characteristics in TACO/FC-STRs. RESULTS: The frequency of TACO/FC-STRs was 0.19% per all RBC units transfused (1:530 units transfused). Both clinically and statistically (p≤0.05) significant changes were encountered in all VSVs in patients experiencing TACO/FC-STRs either at the 15-minute time interval or at the end-of-transfusion time points. Measured and derived VSVs related to the patients' blood pressure in the peritransfusion period were consistently increased. Approximately two-thirds of TACO/FC-STR patients also exhibited inflammatory related signs and symptoms at STR bedside presentation. Differences (all p≤0.050) between UCT and TACO/FC-STR cohorts were seen for patient mean weights (80 kg vs. 72 kg), mean minutes to transfusion completion (121 min vs. 83 min), and mean storage age of suspected sentinel RBC unit (22.5 days vs. 25.2 days). CONCLUSION: Trend monitoring of peritransfusion VSVs, especially blood pressures, may aid in the bedside recognition of TACO/FC-STRs. A subset of these patients may also present with febrile and/or inflammatory signs and symptoms.
Authors: E A Gehrie; N H Roubinian; D Chowdhury; D J Brambilla; E L Murphy; J L Gottschall; Y Wu; P M Ness; R G Strauss; J E Hendrickson Journal: Vox Sang Date: 2017-12-25 Impact factor: 2.144
Authors: N H Roubinian; J E Hendrickson; D J Triulzi; J L Gottschall; D Chowdhury; D J Kor; M R Looney; M A Matthay; S H Kleinman; D Brambilla; E L Murphy Journal: Vox Sang Date: 2016-12-21 Impact factor: 2.144
Authors: Robert B Klanderman; Joachim J Bosboom; Denise P Veelo; Joris J T H Roelofs; Dirk de Korte; Robin van Bruggen; Liffert Vogt; Jaap D van Buul; Markus W Hollmann; Margreeth B Vroom; Nicole P Juffermans; Bart F Geerts; Alexander P J Vlaar Journal: Sci Rep Date: 2022-07-15 Impact factor: 4.996
Authors: Matthew A Warner; Ian J Welsby; Phillip J Norris; Christopher C Silliman; Sarah Armour; Erica D Wittwer; Paula J Santrach; Laurie A Meade; Lavonne M Liedl; Chelsea M Nieuwenkamp; Brian Douthit; Camille M van Buskirk; Phillip J Schulte; Rickey E Carter; Daryl J Kor Journal: BMJ Open Date: 2017-08-18 Impact factor: 2.692
Authors: Robert B Klanderman; Joachim J Bosboom; Adrie A W Maas; Joris J T H Roelofs; Dirk de Korte; Robin van Bruggen; Jaap D van Buul; Coert J Zuurbier; Denise P Veelo; Markus W Hollmann; Margreeth B Vroom; Nicole P Juffermans; Bart F Geerts; Alexander P J Vlaar Journal: Transfusion Date: 2019-11-07 Impact factor: 3.157