Transfusion‐associated circulatory overload after plasma transfusion

Narick, Christina; Triulzi, Darrell J.; Yazer, Mark H.

doi:10.1111/j.1537-2995.2011.03247.x

Cited by 192 publications

(147 citation statements)

References 15 publications

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“…Circulatory overload as seen in TACO is one of the most frequent potentially severe complication of RBC transfusion [16]. Unfortunately, it is also one of the most underreported and under-diagnosed complication of BT [17,18]. An active surveillance system as demonstrated in our study can improve reporting of such complications and prevent such potential morbidities and mortalities due to BT.…”

Section: Discussionmentioning

confidence: 84%

Active Hemovigilance Significantly Improves Reporting of Acute Non-infectious Adverse Reactions to Blood Transfusion

Agnihotri

2015

Indian J Hematol Blood Transfus

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One of the key purposes of a hemovigilance program is to improve reporting of transfusion related adverse events and subsequent data-driven improvement in blood transfusion (BT) practices. We conducted a study over 3 years to assess the impact of healthcare worker training and an active feedback programme on reporting of adverse reactions to BTs. All hospitalized patients who required a BT were included in the study. Healthcare workers involved in BT to patients were sensitized and trained in adverse reaction reporting by conducting training sessions and meetings. All the transfused patients were 'actively' monitored for any acute adverse reaction by using a uniquely coded blood issue form. A total of 18,914 blood components transfused to 5785 different patients resulted in 61 adverse reaction episodes. This incidence of 0.32 % in our study was found to be significantly higher (p \ 0.005) than that reported from the same region in the past. Red blood cell units were the most frequently transfused component and thus most commonly involved in an adverse reaction (42.6 %), however apheresis platelets had the highest chance of reaction per unit transfused (0.66 %). There was no mortality associated with the BT during the study period. An active surveillance program significantly improves reporting and management of adverse reactions to BTs.

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Section: Discussionmentioning

confidence: 84%

Active Hemovigilance Significantly Improves Reporting of Acute Non-infectious Adverse Reactions to Blood Transfusion

Agnihotri

2015

Indian J Hematol Blood Transfus

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“…Plasma-induced TACO has been estimated to be drastically underreported, and the prevalence may be significantly higher than commonly thought. 30 Even without the potential adverse effects related to the volumes of fluid required in FP, the time necessary to prepare and complete the infusion safely may result in a lengthy duration of treatment. Other risks related to FP transfusion, such as TRALI, pathogen transmission, and severe allergic reactions, should also be weighed as risks when considering the use of FP.…”

Section: Contraindicationsmentioning

confidence: 99%

“…Other risks related to FP transfusion, such as TRALI, pathogen transmission, and severe allergic reactions, should also be weighed as risks when considering the use of FP. 27,30 Despite published guidelines for FP transfusion, a recent five-day audit of FP utilization in 76 hospitals in Ontario found that, overall, only 29% of patients transfused with FP received optimal therapy, including both the correct dose and the appropriate indication for use. 31 The most common inappropriate uses for FP were for patients with an INR \ 1.5 or when administered to patients for warfarin reversal in the absence of bleeding.…”

Section: Contraindicationsmentioning

confidence: 99%

“…On estime que la TACO induite par le plasma est sous-rapportée, et le taux de prévalence pourrait être significativement plus élevé que ce que l'on pense. 30 Même sans les effets néfastes potentiels liés aux volumes liquidiens nécessaires pour le PFC, le temps requis afin d'en compléter l'administration de manière sécuritaire pourrait entraîner des délais thérapeutiques indésirables. D'autres risques liés à la transfusion de PFC, tels le TRALI, la transmission de pathogènes et les réactions allergiques graves devraient également être considérés lorsqu'on envisage l'utilisation de PFC.…”

Section: Contre-indicationsunclassified

“…D'autres risques liés à la transfusion de PFC, tels le TRALI, la transmission de pathogènes et les réactions allergiques graves devraient également être considérés lorsqu'on envisage l'utilisation de PFC. 27,30 Malgré les directives publiées en matière de transfusion du PFC, un récent audit de cinq jours portant sur l'utilisation de PFC dans 76 hôpitaux ontariens a rapporté que globalement, seuls 29 % des patients transfusés avec du PFC ont reçu un traitement optimal, à la bonne dose et pour une indication reconnue. 31 Les utilisations inadaptées les plus courantes du PFC étaient liées à des patients avec un RIN \ 1,5, ou lorsqu'il était administré à des patients pour neutraliser la warfarine en l'absence de saignements.…”

Section: Contre-indicationsunclassified

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Reversal of warfarin anticoagulation for urgent surgical procedures

Curtis

Schweitzer

Vlymen

2015

Can J Anesth/J Can Anesth

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Purpose Patients treated with warfarin for therapeutic anticoagulation present a challenge for the perioperative management of urgent and emergent surgery. Anticoagulation must be reversed prior to most surgical procedures to prevent intraoperative bleeding. The purpose of this module is to review the options for urgent reversal of warfarin anticoagulation and the indications for each reversal agent. Selection of the appropriate agent is important to reduce unnecessary complications of treatment and to achieve optimal reversal of anticoagulation. Principal findings When urgent surgery is required for patients taking warfarin, intravenous vitamin K 1 should be used for procedures that can be delayed for six to 12 hr. Vitamin K 1 results in the activation of existing clotting factors rather than requiring the synthesis of new proteins, which allows for its relatively rapid onset of action. Intravenous vitamin K 1 acts more quickly than oral administration, with reversal of anticoagulation occurring within six to 12 hr vs 18-24 hr, respectively. If surgery cannot be delayed, prothrombin complex concentrates (PCCs) should be given, and intravenous vitamin K 1 should be infused concurrently to ensure sustained reversal of anticoagulation. The duration of action of both PCCs and plasma is six hours due to the short half-life of factor VII. Prothrombin complex concentrates contain small amounts of heparin and are contraindicated in patients with heparin-induced thrombocytopenia. Plasma should be used only if PCCs are unavailable or are contraindicated. Conclusion Reversal of warfarin anticoagulation can be achieved in a safe and timely manner when the appropriate agent is selected and administered correctly. Objectives of this Continuing Professional Development (CPD) module:After reading this module, the reader should be able to: 1. Identify the options for emergency reversal of warfarin anticoagulation; 2. Describe the dose, onset, and duration of action of agents that reverse warfarin anticoagulation; 3. List potential complications and contraindications of agents that reverse warfarin anticoagulation; 4. Choose the optimal agent for emergency reversal of warfarin anticoagulation, considering the timing of the operation and the risks and benefits of each agent.Despite increasing use of novel agents, warfarin remains the most widely prescribed oral anticoagulant in clinical use. A recent analysis of prescribing trends following regulatory approval for the newer agents showed that warfarin still accounted for over 75% of all the oral anticoagulants used. 1 Warfarin is indicated to reduce the risk of thromboembolic events in patients with atrial fibrillation, mechanical heart valves, and deep venous thrombosis, among other indications. Therefore, as the population ages, the use of anticoagulants, including warfarin, is projected to increase substantially.Patients treated with warfarin for therapeutic anticoagulation present a challenge for the perioperative management of urgent and emergent surgery. In order to...

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Association of Convalescent Plasma Therapy With Survival in Patients With Hematologic Cancers and COVID-19

Thompson

Henderson

Shah³

et al. 2021

JAMA Oncol

164

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IMPORTANCE COVID-19 is a life-threatening illness for many patients. Prior studies have established hematologic cancers as a risk factor associated with particularly poor outcomes from COVID-19. To our knowledge, no studies have established a beneficial role for anti-COVID-19 interventions in this at-risk population. Convalescent plasma therapy may benefit immunocompromised individuals with COVID-19, including those with hematologic cancers.OBJECTIVE To evaluate the association of convalescent plasma treatment with 30-day mortality in hospitalized adults with hematologic cancers and COVID-19 from a multi-institutional cohort. DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study using data from the COVID-19 and Cancer Consortium registry with propensity score matching evaluated patients with hematologic cancers who were hospitalized for COVID-19. Data were collected between

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Transfusion‐associated circulatory overload after plasma transfusion

Abstract: Passive reporting of TACO grossly underestimates its actual prevalence. Educational efforts are needed to enhance physician recognition of TACO reactions.

Cited by 192 publications

References 15 publications

Active Hemovigilance Significantly Improves Reporting of Acute Non-infectious Adverse Reactions to Blood Transfusion

Active Hemovigilance Significantly Improves Reporting of Acute Non-infectious Adverse Reactions to Blood Transfusion

Reversal of warfarin anticoagulation for urgent surgical procedures

Association of Convalescent Plasma Therapy With Survival in Patients With Hematologic Cancers and COVID-19

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