Transfusion‐associated circulatory overload and high blood pressure: A multicentre retrospective study in Japan

Abstract

Background Transfusion‐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. Methods A 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. Results In 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. Conclusion Our 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.

Machine Learning for Detecting Blood Transfusion Needs Using Biosignals

“…3 illustrates the five extracted features from 1-min ECG and PPG waveforms. PTT is the time measured for the arterial pulse pressure wave to travel from the aortic valve to a peripheral site [21][22][23]. The mPTT-peak represents the mean time interval between the R-peak of ECG and the pulse peak of PPG.…”

“…Third, this study extracted three features from NIBP: mean diastolic BP (mBP-dias), mean systolic BP (mBP-sys), and mean of mean arterial BP (mBP-mean). A few studies observed that BP is associated with transfusion [23,28]. Last, this study considered the variance of PPG amplitudes (vPPG-amp), mean of SpO2 level (mSpO2), and mean respiration.…”