Table IV.
Vital signs in patients who developed transfusion-associated circulatory overload or transfusion-associated dyspnoea prior to and after red blood cell transfusion.
| Admission diagnosis | Charlson’s index | Hb at transfusion* (RBC) | BP at transfusion onset | HR at transfusion onset | Dyspnoea (RR) at transfusion onset | RBC provided | Dyspnoea exacerbated (RR) | Tachycardia exacerbated/(HR) | Hypertension exacerbated/BP | Pulmonary oedema | Renal dysfunction: serum creatinine >90 μmol/L ** | Treatment | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Transfusion-associated circulatory overload (TACO) (Median age: 88 years; range, 68–95) | |||||||||||||
| TACO1 | COPD. dyspnoea | 2 | 7.8 | 180/95 | 112 | Yes (28) | 2 | Yes (38) | Yes (160) | Yes 205/120 | No/rhonchi | 83 | Solumedrole IV |
| TACO2 | COPD. septicaemia | 1 | 9.1 | 91/53 | 105 | Yes (25) | 1 | Yes (40) | Yes (160) | Yes 178/100 | Yes/desaturation | 101↑ | Furosemide 80 mg IV |
| TACO3 | Anaemia | 0 | 4.3 | 135/55 | 80 | Yes (25) | 2 | Yes (28) | No (93) | Yes 186/95 | Yes | 78 | Furosemide 40 mg IV |
| TACO4 | Congestive heart failure | 1 | 7.5 | 130/58 | 88 | No (16) | 1 | Yes (40) | No (90) | Yes 172/85 | No/stridor | 127↑ | Nitroglycerine/upright position |
| TACO5 | Congestive heart failure | 2 | 8.5 | 170/115 | 85 | No (17) | 1 | Yes (36) | No (123) | Yes 250/100 | No | 87 | Furosemide/nitroglycerine |
| Transfusion-associated dyspnoea (TAD) (Median age: 86 years; range, 81–98) | |||||||||||||
| TAD1 | Congestive heart failure | 3 | 8.6 | 135/68 | 61 | Yes (23) | 2 | Yes (33) | No (88) | No (172/82) | Yes¶ | 248↑ | Furosemide 40×3 mgi IV, nitroglycerine |
| TAD2 | Pneumonia | 2 | 7.2 | <140/90 | <100 | Yes (25) | 2 | Yes (36) | Yes (110) | Yes 212/109 | Yes¶ | 116↑ | Furosemide 80 – 160 mg IV |
| TAD3 | Congestive heart failure | 1 | 6.7 | 132/88 | 88 | No (20) | 3 | Yes (>26) | No (82) | No (125/60) | No/desaturation** | 47 | Nasal oxygen/furosemide IV |
| TAD4 | Infection/dehydration | 0 | 4.6 | <85/50§§ | <100 | Yes (36)§§ | 5 | No (18) | No (43) | No (100/55) | Yes||| | 149↑ | (See text note) |
*
Haemoglobin in g/dL at onset of transfusion; RBC: red blood cells; RR: respiratory rate; HR: heart rate; BP: blood pressure; ¶ 20–24 hours after transfusion;
**
oxygen desaturation;
§§
dyspnoea on admission;
|||
pulmonary congestion following 2 RBC units;
**
serum creatinine reference value (50–90 μmol/L).