Abstract:
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.
journal_name
Transfusionjournal_title
Transfusionauthors
Andrzejewski C Jr,Popovsky MA,Stec TC,Provencher J,O'Hearn L,Visintainer P,Steingrub Jdoi
10.1111/j.1537-2995.2012.03595.xsubject
Has Abstractpub_date
2012-11-01 00:00:00pages
2310-20issue
11eissn
0041-1132issn
1537-2995journal_volume
52pub_type
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