In:
Transfusion, Wiley, Vol. 58, No. 2 ( 2018-02), p. 498-506
Abstract:
The objective of this study was to determine the incidence, risk factors, and outcome of transfusion‐associated circulatory overload (TACO) in a cohort of mixed intensive care unit patients and to compare risk factors with those for cardiac overload in the absence of transfusion. STUDY DESIGN AND METHODS In a retrospective cohort study, patients who developed TACO were compared using multivariate analysis of two control groups: patients without pulmonary deterioration who received transfusion and patients who developed circulatory overload in the absence of transfusion. RESULTS TACO was diagnosed in 66 of 1140 patients who received transfusions (5.8%). A total of 585 control transfusion recipients and 76 control patients who developed circulatory overload also were identified. Risk factors were the referring specialties cardiology (odds ratio [OR], 13.6; 95% confidence interval [CI] , 5.1‐35.7; p ≤ 0.001) and cardiothoracic surgery (OR, 8.8; 95% CI, 3.7‐20.7; p ≤ 0.001), history of cardiac failure (OR, 2.4; 95% CI, 1.2‐4.6; p = 0.01), continuous veno‐venous hemofiltration (OR, 3.2; 95% CI, 1.2‐8.9; p = 0.03), and degree of positive fluid balance (OR, 1.15; 95% CI, 1.07‐1.24; p ≤ 0.001), which was associated less with the onset of TACO compared with circulatory overload (OR, 0.89; 95% CI, 0.82‐0.97; p = 0.005). Patients in the TACO group had a longer length of stay in the intensive care unit compared with the transfusion and circulatory overload controls groups (median, 7.2 vs. 4.3 vs. 4.4 days; p = 0.001 vs. p = 0.008). CONCLUSIONS The incidence of TACO is high in a mixed intensive care unit population. The risk factors identified for TACO are cardiac failure, renal failure, and degree of positive fluid balance. A positive fluid balance may be less essential in the onset of TACO than in the onset of circulatory overload in the absence of transfusion.
Type of Medium:
Online Resource
ISSN:
0041-1132
,
1537-2995
DOI:
10.1111/trf.2018.58.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
208417-X
detail.hit.zdb_id:
2018415-3
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