Transfusion-associated circulatory overload and high blood pressure: A multicentre retrospective study in Japan
Transfusion-associated circulatory overload and high blood pressure: A multicentre retrospective study in Japan
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输血相关的循环超负荷和高血压：日本的一项多中心回顾性研究
DOI：
10.1111/vox.13063
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Muroi K.
中科院分区：
文献类型：
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作者：
Tanaka A;Yokohama A;Fujiwara SI;Fujii Y;Kaneko M;Ueda Y;Abe T;Kato Y;Hasegawa Y;Ikeda K;Fujino K;Matsumoto M;Makino S;Kino S;Takeshita A;Muroi K.
输血相关循环超负荷（TACO）是一种与死亡风险高相关的不良反应。TACO和高血压与输血在日本的实际发病率是unknown.MethodsA多中心回顾性观察研究在23个机构在1年期间的2016.如果患者在输血过程中发生TACO或血压（收缩压或舒张压）升高至少30 mmHg，则纳入研究。TACO被确认的初级医生和输血医学团队和被动监测的数据记录，并从电子病历中提取额外的数据。结果在我们的患者队列的31 384例接受输血，TACO和高血压的发病率分别为0.03%和0.2%。然而，43%的参与机构没有报告任何病例。当比较TACO和高血压组之间的风险因素时，合并症存在显著差异，例如胸部X线检查异常结果。两组患者输血后脉率、体温、血氧饱和度比较差异有统计学意义（P< 0·01）。高血压组中45%（5/11）的患者输血后BNP水平显著升高。我们确定了4例高血压组谁符合新的ISBT的TACO criterion.ConclusionOur研究表明，应给予更多的关注TACO在日本，特别是在改善监测系统方面。对于TACO的早期诊断，仔细监测包括血压在内的生命体征至关重要。
BackgroundTransfusion‐associated circulatory overload (TACO) is an adverse reaction associated with a high risk of mortality. The actual incidence of TACO and hypertension associated with transfusion in Japan is unknown.MethodsA multicentre retrospective observational study was conducted across 23 institutions during the 1‐year period of 2016. Patients were included if they developed TACO or their blood pressure (either systolic or diastolic) increased by at least 30 mmHg during the transfusion. TACO was confirmed by the primary physicians and transfusion medicine teams and recorded in the data on passive surveillance, and additional data were extracted from electronic medical records.ResultsIn our patient cohort of 31 384 patients who underwent transfusion, the incidence of TACO and hypertension was 0·03% and 0·2%, respectively. However, 43% of the participating institutions didn't report any cases. When comparing risk factors between the TACO and hypertension groups, there were significant differences in comorbidities, such as abnormal findings on chest x‐ray. Significant differences between the two groups were observed post‐transfusion pulse rate, body temperature and oxygen saturation (P< 0·01). In the group of patients with hypertension, the level of BNP increased significantly after transfusion in 45% (5/11) of the patients. We identified 4 patients in the hypertension group who met the new ISBT’s TACO criteria.ConclusionOur study suggests that more attention should be given to TACO in Japan, particularly in terms of improving surveillance systems. For the early diagnosis of TACO, it is crucial to carefully monitor vital signs including blood pressure.