Updated definitions for respiratory complications of blood transfusion

Schipperus, Martin R.; Wiersum‐Osselton, Johanna C.

doi:10.1111/trf.15389

Cited by 6 publications

(10 citation statements)

References 1 publication

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“…Important criteria for TACO are either respiratory compromise or pulmonary oedema [1]. In the present study, we did not find significant differences between groups in any of the markers for acute lung injury, that we measured.…”

Section: Discussioncontrasting

confidence: 63%

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Can volume‐reduced plasma products prevent transfusion‐associated circulatory overload in a two‐hit animal model?

et al. 2023

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Background and Objectives Transfusion‐associated circulatory overload (TACO) is a pulmonary transfusion complication and a leading cause of transfusion‐related morbidity and mortality. Volume overload and rising hydrostatic pressure as a consequence of transfusion are seen as the central pathway leading to TACO. A possible preventative measure for TACO could be the use of low‐volume blood products like volume‐reduced lyophilized plasma. We hypothesize that volume‐reduced lyophilized plasma decreases circulatory overload leading to a reduced pulmonary capillary pressure and can therefore be an effective strategy to prevent TACO. Materials and Methods A validated two‐hit animal model in rats with heart failure was used. Animals were randomized to receive 4 units of either solvent‐detergent pooled plasma (SDP) as control, standard volume lyophilized plasma (LP‐S) or hyperoncotic volume‐reduced lyophilized plasma (LP‐VR). The primary outcome was the difference between pre‐transfusion and post‐transfusion left ventricular end‐diastolic pressure (ΔLVEDP). Secondary outcomes included markers for acute lung injury. Results LVEDP increased in all randomization groups following transfusion. The greatest elevation was seen in the group receiving LP‐VR (+11.9 mmHg [5.9–15.6]), but there were no significant differences when compared to groups receiving either LP‐S (+6.3 mmHg [2.9–13.4], p = 0.29) or SDP (+7.7 mmHg [4.5–10.5], p = 0.55). There were no significant differences in markers for acute lung injury, such as pulmonary wet/dry weight ratios, lung histopathology scores or PaO2/FiO2 ratio between the three groups. Conclusion Transfusion with hyperoncotic volume‐reduced plasma did not attenuate circulatory overload compared to standard volume plasma and was therefore not an effective preventative strategy for TACO in this rat model.

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Section: Discussioncontrasting

confidence: 63%

“…Transfusion-associated circulatory overload (TACO) is a pulmonary transfusion complication [1]. TACO is still responsible for about one third of transfusion-related deaths in spite of adopted transfusion practices [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Can volume‐reduced plasma products prevent transfusion‐associated circulatory overload in a two‐hit animal model?

et al. 2023

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“…This holds true for both the absolute NT‐proBNP value and the post to pre‐transfusion NT‐proBNP ratio. Since the NT‐proBNP levels were already elevated pre‐transfusion and did not significantly increase during transfusion, the NT‐proBNP ratio remained below the cutoff value of 1.5 that has been stated in the most recent definition of TACO 6 . When we explored other possible markers, we found that syndecan‐1 was elevated in TACO patients compared to non‐TACO patients at all timepoints.…”

Section: Discussionmentioning

confidence: 65%

“…Patients that had at least three criteria present were categorized as TACO. The chosen criteria were derived from the most recent TACO surveillance definition 6 . Patient data along with blood samples were available retrieved pre‐transfusion (1–2 h prior) and 1 and 24 h after transfusion.…”

Section: Methodsmentioning

confidence: 99%

“…The TACO definition includes five criteria, which are respiratory compromise, pulmonary edema, cardiovascular changes, evidence of fluid overload, and an increase in a relevant biomarker. To classify as TACO, one of the first two criteria and three in total have to be met 6 . However, for most of these criteria, there is no information on timing of measurements or cut‐off values, rendering a diagnosis of TACO challenging.…”

Section: Introductionmentioning

confidence: 99%

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Exploring NT‐proBNP, syndecan‐1, and cytokines as biomarkers for transfusion‐associated circulatory overload in a critically ill patient population receiving a single‐unit red blood cell transfusion

Bulle,

Blanken,

Klanderman

et al. 2023

Transfusion

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BackgroundTransfusion‐associated circulatory overload (TACO) is an often underdiagnosed pulmonary transfusion complication. A biomarker could aid with the diagnosis. To date, B‐type natriuretic peptide (BNP) and N‐terminal prohormone B‐type natriuretic peptide (NT‐proBNP) seem the most promising biomarkers in the general hospital population. The aim was to evaluate NT‐proBNP as a biomarker for TACO in a critically ill patient population and explore syndecan‐1 and cytokines as other potential biomarkers.Study Design and MethodsA retrospective study was performed using samples and clinical data collected during a prospective observational study. Adult patients admitted to the intensive care and transfused with a single red blood cell unit were included. TACO cases were retrospectively identified using a case definition based on the current TACO definition. The primary biomarker was NT‐proBNP, also we measured syndecan‐1 IL‐6, IL‐8, and IL‐10. All markers were measured directly before transfusion, 1 and 24 h after transfusion.ResultsOur cohort included 64 patients, 12 of which were identified as TACO patients. TACO patients had a lower PaO2/FiO2 ratio and were more often ventilated following transfusion compared to non‐TACO patients. There was no significant difference in NT‐proBNP between pre‐ and post‐transfusion levels nor between TACO and non‐TACO patients. Syndecan‐1 was significantly elevated in TACO patients both pre‐ and post‐transfusion compared to non‐TACO patients.DiscussionNT‐proBNP was not associated with TACO in this critically ill patient population. Interestingly, levels of syndecan‐1 were increased in TACO patients at baseline. More research is needed to clarify this association and its possibilities as a biomarker to predict patients at risk for TACO.

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The recipe for TACO: A narrative review on the pathophysiology and potential mitigation strategies of transfusion-associated circulatory overload

et al. 2022

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Updated definitions for respiratory complications of blood transfusion

Cited by 6 publications

References 1 publication

Can volume‐reduced plasma products prevent transfusion‐associated circulatory overload in a two‐hit animal model?

Can volume‐reduced plasma products prevent transfusion‐associated circulatory overload in a two‐hit animal model?

Exploring NT‐proBNP, syndecan‐1, and cytokines as biomarkers for transfusion‐associated circulatory overload in a critically ill patient population receiving a single‐unit red blood cell transfusion

The recipe for TACO: A narrative review on the pathophysiology and potential mitigation strategies of transfusion-associated circulatory overload

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