The practice of diagnosing and reporting transfusion-associated circulatory overload: a national survey among physicians and haemovigilance officers

J. J. Bosboom, R. B. Klanderman, A. L. Peters, E. K. van de Weerdt, E. J. Goudswaard, J. M. Binnekade, J. J. Zwaginga, E. A. M. Beckers, B. F. Geerts*, M. W. Hollmann, S. S. Zeerleder, M. van Kraaij, A. P. Vlaar

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Objectives This study aims at identifying factors that disciplines consider when diagnosing and reporting transfusion-associated circulatory overload (TACO'). BackgroundMethodsTACO is a clinical diagnosis based mainly on subjective factors. Therefore, TACO could be an underreported complication of blood transfusion. A survey was conducted among critical care physicians, anaesthesiologists, haematologists, transfusion medicine physicians and haemovigilance officers using case vignettes and a questionnaire. Factors that may affect diagnosing TACO were investigated using conjoint analysis. A positive B-coefficient indicates a positive preference for diagnosing TACO. Participants rated factors influencing reporting TACO on a 0- to 100-point scale. ResultsConclusionOne hundred and seven surveys were returned (62%). Vignettes showed preferences in favour of diagnosing TACO with the onset of symptoms within 2h [ 04(-01-10)], positive fluid balance [ 09(04-15)] and history of renal failure [ 06(01-12)]. Compared with transfusion of a single unit of red blood cells (RBC), respondents showed a preference for diagnosing TACO following a single unit of solvent/detergent (S/D) plasma or pooled platelet concentrate (PPC) [ 03(-02-07) resp. 05(-01-12)]. Multiple transfusion (6 RBC+4S/D plasma) was a strong preference for diagnosing TACO compared to 1 RBC and 1S/D plasma [ 03(-08-13)]. Respondents did not fully take into account new hypertension and tachycardia when reporting TACO [median 70 (IQR 50-80) resp. 60 (IQR 50-80)]. No differences were observed between disciplines involved. When diagnosing and reporting TACO, physicians and haemovigilance officers do consider known risk factors for TACO. Reporting could be improved by increasing the awareness of haemodynamic variables in future education programmes.
Original languageEnglish
Pages (from-to)363-370
Number of pages8
JournalTransfusion Medicine
Volume28
Issue number5
DOIs
Publication statusPublished - 1 Oct 2018

Keywords

  • critical care
  • haematology
  • haemovigilance
  • transfusion
  • volume overload
  • PREVENTION
  • CARE

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