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"Transfusion associated circulatory"

Nathan T Connell
Transfusion of various blood components can provide relief from symptomatic anemia and reduce the bleeding risks associated with low platelet counts or presence of coagulopathy. Blood components are collected from volunteer donors and processed into separate components to maximize efficient utilization of a scarce resource while also providing maximum clinical benefit. Tests including blood type and screening for clinically significant alloantibodies increase the likelihood of successful transfusion. Risks of transfusion include hypersensitivity and hemolytic transfusion reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, and transmission of infection...
December 2016: Primary Care
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
BACKGROUND: Prevalence estimates of the serious hazards of transfusion vary widely. We hypothesized that the current reporting infrastructure in the United States fails to capture many transfusion reactions and undertook a multicenter study using active surveillance, data review, and adjudication to test this hypothesis. STUDY DESIGN AND METHODS: A retrospective record review was completed for a random sample of 17% of all inpatient transfusion episodes over 6 months at four academic tertiary care hospitals, with an episode defined as all blood products released to a patient in 6 hours...
October 2016: Transfusion
Katherine M Prioli, Laura T Pizzi, Julie Katz Karp, Taki Galanis, Jay H Herman
BACKGROUND: Plasma is used to treat acquired coagulopathy or thrombotic thrombocytopenic purpura, or to reverse warfarin effect. Scant data are available, however, about its costs. OBJECTIVE: To estimate total costs of plasma from production through administration, from the perspective of a US hospital blood donor center (BDC). STUDY DESIGN AND METHODS: Six sequential decision analytic models were constructed and informed by primary and secondary data on time, tasks, personnel, and supplies for donation, processing, and administration...
October 2016: Applied Health Economics and Health Policy
E Tseng, J Spradbrow, X Cao, J Callum, Y Lin
OBJECTIVES AND BACKGROUND: There are few studies of quality interventions to mitigate the risk of transfusion-associated circulatory overload (TACO). Our aim was to reduce TACO risk in patients admitted to internal medicine at our hospital, by addressing gaps in transfusion practice. MATERIALS AND METHODS: A 3-month baseline audit of red blood cell (RBC) transfusion orders was conducted. An intervention consisting of a transfusion order set and physician checklist was developed and implemented based on identified gaps, followed by a 3-month post-intervention audit...
April 2016: Transfusion Medicine
Dennis Murphree, Che Ngufor, Sudhindra Upadhyaya, Nagesh Madde, Leanne Clifford, Daryl J Kor, Jyotishman Pathak
Of the 21 million blood components transfused in the United States during 2011, approximately 1 in 414 resulted in complication [1]. Two complications in particular, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO), are especially concerning. These two alone accounted for 62% of reported transfusion-related fatalities in 2013 [2]. We have previously developed a set of machine learning base models for predicting the likelihood of these adverse reactions, with a goal towards better informing the clinician prior to a transfusion decision...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
A L Marshall, M Levine, M L Howell, Y Chang, E Riklin, B A Parry, R T Callahan, I Okechukwu, A M Ayres, B V Nahed, J N Goldstein
UNLABELLED: ESSENTIALS: Fresh frozen plasma (FFP) may be associated with a dose-based risk of pulmonary complications. Patients received FFP for warfarin reversal at a large academic hospital over a 3-year period. Almost 20% developed pulmonary complications, and the risk was highest after > 3 units of FFP. The risk of pulmonary complications remained significant in multivariable analysis. BACKGROUND: Fresh frozen plasma (FFP) is often administered to reverse warfarin anticoagulation...
February 2016: Journal of Thrombosis and Haemostasis: JTH
Makoto Handa
The risks associated with transfusion with blood components have been greatly reduced due to the implementation of innovative strategies for donor selection and testing, as well as safety measures such as universal prestorage leukocyte reduction. However, a variety of residual or unsolved risks, such as severe acute reaction of transfusion-related acute lung injury, transfusion-associated circulatory overload and transfusion-transmitted infections, remain. Patients with hematological disorders are at high risk, since they receive therapeutic interventions frequently requiring transfusion...
October 2015: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Christopher A Jones, Katrina Ducis, Jeffrey Petrozzino, Eric Clark, Mark K Fung, Christian Peters, Indra Neil Sarkar, Emilia Krol, Brina Pochal, Amanda Boutrus, Peter Weimersheimer, Kalev Freeman
INTRODUCTION: Fresh frozen plasma (FFP) is a frequently used human blood product to reverse the effects of vitamin K antagonists. While FFP is relatively economical, its large fluid volume can lead to hospitalization complications, therefore increasing the overall cost of use. MATERIALS & METHODS: A recently published article by Sarode et al., in Circulation, described the rate of volume overload associated with FFP use for reversal of vitamin K antagonists. This condition, described as transfusion-associated circulatory overload, has a defined rate of intensive care admission, which also has a well-reported average cost...
2016: Expert Review of Pharmacoeconomics & Outcomes Research
Kyu Nam Kim, Dong Won Kim, Mi Ae Jeong
BACKGROUND: Transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO) are leading causes of transfusion-related mortality. An electronic medical record-based screening classification and regression tree (CART) algorithm was previously developed for predicting transfusion-related pulmonary complications. In the Republic of Korea, TRALI is not sufficiently recognized and an accurate TRALI incidence has not been reported. Therefore, we carried out this study to assess the incidence of TRALI and to determine whether the CART algorithm can be applied to our hospital data...
November 2015: Transfusion
Klaus Görlinger, Fuat H Saner
It is still common practice to correct abnormal standard laboratory test results, such as increased INR or low platelet count, prior to invasive interventions, such as tracheostomy, central venous catheter insertion or liver biopsy, in critically ill patients. Data suggest that 30-90 % of plasma transfused for these indications is unnecessary and puts the patient at risk. Plasma transfusion is associated with a high risk of transfusion-associated adverse events such as transfusion-associated circulatory overload (TACO), transfusion-related lung injury (TRALI), transfusion-related immunomodulation (TRIM), and anaphylaxis/allergic reactions...
2015: BMC Anesthesiology
K G Badami, E Joliffe, M Stephens
New Zealand Blood Service Haemovigilance uses International Society of Blood Transfusion/International Haemovigilance Network definitions to categorize transfusion reactions (TR). Transfusion-associated dyspnoea (TAD) is a category for TR with respiratory features (TRRF) that do not fit definitive entities. TRRF, including TAD, are clinically significant. TR classified as TAD were reviewed. We found that many TAD may have been transfusion-associated circulatory overload. Better information in TR reports and refining TR diagnostic criteria may result in less misclassification of TRRF...
August 2015: Vox Sanguinis
J S Raval, M A Mazepa, S L Russell, C C Immel, H C Whinna, Y A Park
BACKGROUND: Transfusion-associated circulatory overload (TACO) is the second leading cause of reported transfusion-related fatalities in the United States. While its occurrence has been previously investigated after red cell and plasma transfusion, no data are available regarding its association with platelet transfusion. Our goal was to determine the rate of platelet-associated TACO at our university medical centre. STUDY DESIGN AND METHODS: This study had retrospective and prospective analyses...
May 2015: Vox Sanguinis
Nareg H Roubinian, Mark R Looney, Daryl J Kor, Clifford A Lowell, Ognjen Gajic, Rolf D Hubmayr, Michael A Gropper, Monique Koenigsberg, Gregory A Wilson, Michael A Matthay, Pearl Toy, Edward L Murphy
BACKGROUND: Pulmonary transfusion reactions are important complications of blood transfusion, yet differentiating these clinical syndromes is diagnostically challenging. We hypothesized that biologic markers of inflammation could be used in conjunction with clinical predictors to distinguish transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), and possible TRALI. STUDY DESIGN AND METHODS: In a nested case-control study performed at the University of California at San Francisco and Mayo Clinic, Rochester, we evaluated clinical data and blood samples drawn before and after transfusion in patients with TRALI (n = 70), possible TRALI (n = 48), TACO (n = 29), and controls (n = 147)...
August 2015: Transfusion
Michael Sarai, Aaron M Tejani
BACKGROUND: Blood transfusions are associated with significant morbidity and mortality. Prophylactic administration of loop diuretics (furosemide, bumetanide, ethacrynic acid, or torsemide) is common practice, especially among people who are at risk for circulatory overload, pulmonary oedema or both. OBJECTIVES: This review aimed to determine if the prophylactic administration of loop diuretics (furosemide, bumetanide, ethacrynic acid, or torsemide) provides a therapeutic advantage (that is, a favourable risk benefit ratio) in adults and children who are recipients of any blood product transfusion versus placebo, no treatment, or general fluid restriction measures...
2015: Cochrane Database of Systematic Reviews
Leanne Clifford, Qing Jia, Hemang Yadav, Arun Subramanian, Gregory A Wilson, Sean P Murphy, Jyotishman Pathak, Darrell R Schroeder, Mark H Ereth, Daryl J Kor
BACKGROUND: Transfusion-associated circulatory overload (TACO) is a leading cause of transfusion-related fatalities, but its incidence and associated patient and transfusion characteristics are poorly understood. To inform surgical transfusion practice and to begin mitigating perioperative TACO, the authors aimed to define its epidemiology. METHODS: In this retrospective cohort study, the medical records of adult patients undergoing noncardiac surgery with general anesthesia during 2004 or 2011 and receiving intraoperative transfusions were screened using an electronic algorithm for identification of TACO...
January 2015: Anesthesiology
Andrea Piccin, Marina Cronin, Róisín Brady, Jackie Sweeney, Luigi Marcheselli, Emer Lawlor
BACKGROUND: Transfusion-associated circulatory overload (TACO) is an increasingly reported condition but symptoms and signs are still unrecognized. We present a review of the incidence and clinical features of TACO reported to the National Haemovigilance Office at the Irish Blood Transfusion Service. STUDY DESIGN AND METHODS: Between 2000 and 2010, a total of 1071 cases of serious transfusion-related reactions were reported, of which 221 (21%) cases were TACO. RESULTS: A total of 2,000,684 blood components were issued, with a TACO incidence of one in 9177...
June 2015: Transfusion
Dragica Sović, Javorka Dodig, Miroslav Banović, Anamarija Jularić
Transfusion treatment is administered according to clinical and laboratory results, with ongoing patient assessments. Decisions on necessary measures to prevent any adverse and unexpected events and reactions are made on the basis ofhemovigilance and ongoing gathering and analysis of relevant data. Information about transfusion treatment at the Sestre milosrdnice University Hospital Center, Vinogradska site, was retrospectively collected for a period of twelve years (2001-2012). In that period, 14137.25 ± 1693...
September 2014: Acta Clinica Croatica
Radhika Dasararaju, Marisa B Marques
BACKGROUND: Patients with malignancy comprise a unique group for whom transfusions play an important role. Because the need for transfusions may span a long period of time, these patients may be at risk for more adverse events due to transfusion than other patient groups. METHODS: A literature search on PubMed that included original studies and reviews was performed. The results were summarized and complemented by our clinical experience. Long-term complications of transfusions, such as transfusion-associated graft-vs-host disease, alloimmunization, transfusion-related immunomodulation, and iron overload, are discussed...
January 2015: Cancer Control: Journal of the Moffitt Cancer Center
Karthikeyan E Ponnusamy, Thomas J Kim, Harpal S Khanuja
Blood transfusion after orthopaedic surgery accounts for 10% of all packed red blood-cell transfusions, but use varies substantially across hospitals and surgeons. Transfusions can cause systemic complications, including allergic reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, graft-versus-host disease, and infections. Tranexamic acid is a new cost-effective blood management tool to reduce blood loss and decrease the risk of transfusion after total joint arthroplasty...
November 5, 2014: Journal of Bone and Joint Surgery. American Volume
S Mallaiah, P Barclay, I Harrod, C Chevannes, A Bhalla
We compared blood component requirements during major obstetric haemorrhage, following the introduction of fibrinogen concentrate. A prospective study of transfusion requirements and patient outcomes was performed for 12 months to evaluate the major obstetric haemorrhage pathway using shock packs (Shock Pack phase). The study was repeated after the pathway was amended to include fibrinogen concentrate (Fibrinogen phase). The median (IQR [range]) number of blood components given was 8.0 (3.0-14.5 [0-32]) during the Shock Pack phase, and 3...
February 2015: Anaesthesia
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