Incidence and transfusion risk factors for transfusion-associated circulatory overload among medical intensive care unit patients.
Transfusion
; 51(2): 338-43, 2011 Feb.
Article
en En
| MEDLINE
| ID: mdl-20723173
ABSTRACT
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 ANDMETHODS:
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.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Edema Pulmonar
/
Lesión Pulmonar Aguda
/
Reacción a la Transfusión
/
Unidades de Cuidados Intensivos
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Transfusion
Año:
2011
Tipo del documento:
Article
País de afiliación:
Estados Unidos