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Standardized reporting of pulmonary transfusion complications: Development of a model reporting form and flowchart |
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| Authors: | Stefan F. van Wonderen Anna L. Peters Sharran Grey Srijana Rajbhandary Layla L. de Jonge Chester Andrzejewski Jr Shruthi Narayan Johanna C. Wiersum-Osselton Alexander P. J. Vlaar |
| Affiliation: | 1. Department of Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands;2. Division Vital Functions, Department of Anesthesiology, University Medical Center Utrecht, University of Utrecht, Utrecht, Netherlands;3. Lancashire Haematology Centre, Blackpool Teaching Hospitals NHS Foundation Trust, North Lancashire, UK Serious Hazards of Transfusion, Manchester, UK;4. Department of Research, Association for the Advancement of Blood and Biotherapies, Bethesda, Maryland, USA;5. TRIP (Transfusion and Transplantation Reactions in Patients) Hemovigilance and Biovigilance Office, Leiden, Netherlands;6. Department of Pathology, Transfusion and Apheresis Medicine Services, Baystate Medical Center, Baystate Health, Springfield, Massachusetts, USA;7. Serious Hazards of Transfusion, Manchester, UK National Health Service Blood and Transplant, UK |
| Abstract: | BackgroundPulmonary complications of blood transfusion, including transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), and transfusion-associated dyspnea, are generally underdiagnosed and under-reported. The international TRALI and TACO definitions have recently been updated. Currently, no standardized pulmonary transfusion reaction reporting form exists and most of the hemovigilance forms have not yet incorporated the updated definitions. We developed a harmonized reporting form, aimed at improved data collection on pulmonary transfusion reactions for hemovigilance and research purposes by developing a standardized model reporting form and flowchart.Materials and MethodsUsing a modified Delphi method among an international, multidisciplinary panel of 24 hemovigilance experts, detailed recommendations were developed for a standardized model reporting form for pulmonary complications of blood transfusion. Two Delphi rounds, including scoring systems, took place and several subsequent meetings were held to discuss issues and obtain consensus. Additionally, a flowchart was developed incorporating recently published redefinitions of pulmonary transfusion reactions.ResultsIn total, 17 participants completed the first questionnaire (70.8% response rate) and 14 participants completed the second questionnaire (58.3% response rate). According to the results from the questionnaires, the standardized model reporting form was divided into various subcategories: general information, patient history and transfusion characteristics, reaction details, investigations, treatment and supportive care, narrative, and transfused product.ConclusionIn this article, we present the recommendations from a global group of experts in the hemovigilance field. The standardized model reporting form and flowchart provide an initiative that may improve data collected to address pulmonary transfusion reactions. |
| Keywords: | anaphylaxis flowchart hemovigilance reporting transfusion-associated circulatory overload transfusion-associated dyspnea transfusion-related acute lung injury |