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N‐terminal pro‐brain natriuretic peptide is a useful diagnostic marker for transfusion‐associated circulatory overload
Author(s) -
Tobian Aaron A.R.,
Sokoll Lori J.,
Tisch Daniel J.,
Ness Paul M.,
Shan Hua
Publication year - 2008
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2008.01656.x
Subject(s) - medicine , asymptomatic , n terminal pro brain natriuretic peptide , natriuretic peptide , volume overload , brain natriuretic peptide , logistic regression , cardiology , circulatory system , blood volume , intensive care medicine , heart failure
BACKGROUND: Transfusion‐associated circulatory overload (TACO) can be difficult to diagnose and distinguish from transfusion‐related acute lung injury (TRALI), but is a relatively common complication that occurs when increases in blood volume overwhelm the cardiovascular system. Brain natriuretic peptide (BNP) has been shown to be a functional marker for TACO. N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) is another marker that could be more helpful than BNP since it has a longer half‐life in circulation and is also much more stable in laboratory samples. In this study, whether NT‐proBNP is a useful diagnostic marker for TACO was evaluated. STUDY DESIGN AND METHODS: Forty patients were enrolled into a case‐control study (16 patients with TACO and 24 control patients) and had pre‐ and posttransfusion NT‐proBNP concentrations evaluated from submitted type‐and‐screen blood samples. RESULTS: The sensitivity of elevated posttransfusion NT‐proBNP to diagnose TACO was 93.8 percent, the specificity was 83.8 percent, and the accuracy was 87.5 percent. Elevated posttransfusion NT‐proBNP is the only independent variable for the diagnosis of TACO based on multivariate logistic regression. CONCLUSION: NT‐proBNP is both a sensitive and a specific marker for TACO and can be helpful in confirming transfusion associated fluid overload. This study also demonstrates that many patients who experience TACO may already be in a state of excess volume. Clinicians should be aware that many asymptomatic patients have excess fluid and transfusion may cause these patients to become symptomatic.