ACUTE HYPERTENSIVE CRISIS DURING INFUSION OF HEMATOPOIETIC PROGENITOR CELLS FROM MATCHED UNRELATED DONORS: IDENTIFICATION OF PREDICTIVE FACTORS AND OPTIMAL TREATMENT

2.50
Hdl Handle:
http://hdl.handle.net/10755/164681
Category:
Abstract
Type:
Presentation
Title:
ACUTE HYPERTENSIVE CRISIS DURING INFUSION OF HEMATOPOIETIC PROGENITOR CELLS FROM MATCHED UNRELATED DONORS: IDENTIFICATION OF PREDICTIVE FACTORS AND OPTIMAL TREATMENT
Author(s):
Blackburn, Roxann; Giralt, Sergio; Saliba, Rima; Rondon, Gabriella; Fenwick, Joyce
Author Details:
Roxann Blackburn, RN, OCN, Assistant Nurse Manager, UTMDACC, Houston, Texas, USA, email: rblackbu@mdanderson.org; Sergio Giralt; Rima Saliba Gabriella Rondon; Joyce Fenwick
Abstract:
Topic: Acute hypertensive crisis during autologous hematopoietic progenitor cell (HPC) infusions using DMSO is widely reported, but the literature is silent regarding this event during infusions of HPC from matched unrelated donors (MUD). MUD-HPC infusions are often given by evening nursing staff when there is less clinical support in the hospital, and treatment varies with physician preference. Identification of predictive factors, and of optimal treatment may lead to improved outcomes. Purpose: To identify predictive factors for the development of acute hypertensive crisis and to develop best treatment pathways. Framework: A retrospective chart review of 97 adult patients receiving MUD-HPC infusions from October 2003 - September 2004 was done. Methods: A retrospective chart review of 97 consecutive patients receiving MUD HPC infusions was completed. Demographic, clinical and laboratory factors were evaluated for the occurrence of hypertensive crisis using regression analysis. This analysis was limited to patients receiving HPC-marrow because only 2 of 20 cases occurred among patients receiving peripheral blood stem cell infusions. Hypertension crisis was defined as SBP >160, DBP >100 or a symptomatic increases in BP of 20 mm HG > baseline. Findings: On univariate analysis, volume infused (adjusted for weight), elevated creatinine (>1.0mg/dl) and BUN levels above the median (>15mg/dl) were significant predictors. Because of high correlation between BUN and creatinine, only BUN was considered in multivariate analysis (higher precision associated with the estimate). Patients receiving high volume infusions with an elevated BUN were at the greatest risk (62%), followed by patients receiving high volume infusions and low BUN (28%), and then by patients receiving low volume and high BUN (17%). There were no cases of hypertension among the 18 patients who received low volumes and had a low BUN. Medical treatment during hypertensive episodes varied by best responses was seen with combined use of IV antihypertensive agents and diuretics. These findings suggest that volume reduction of HPC-M may decrease the incidence of acute hypertensive crisis during MUD infusions.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2006
Conference Name:
31st Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Boston, Massachusetts, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleACUTE HYPERTENSIVE CRISIS DURING INFUSION OF HEMATOPOIETIC PROGENITOR CELLS FROM MATCHED UNRELATED DONORS: IDENTIFICATION OF PREDICTIVE FACTORS AND OPTIMAL TREATMENTen_GB
dc.contributor.authorBlackburn, Roxannen_US
dc.contributor.authorGiralt, Sergioen_US
dc.contributor.authorSaliba, Rimaen_US
dc.contributor.authorRondon, Gabriellaen_US
dc.contributor.authorFenwick, Joyceen_US
dc.author.detailsRoxann Blackburn, RN, OCN, Assistant Nurse Manager, UTMDACC, Houston, Texas, USA, email: rblackbu@mdanderson.org; Sergio Giralt; Rima Saliba Gabriella Rondon; Joyce Fenwicken_US
dc.identifier.urihttp://hdl.handle.net/10755/164681-
dc.description.abstractTopic: Acute hypertensive crisis during autologous hematopoietic progenitor cell (HPC) infusions using DMSO is widely reported, but the literature is silent regarding this event during infusions of HPC from matched unrelated donors (MUD). MUD-HPC infusions are often given by evening nursing staff when there is less clinical support in the hospital, and treatment varies with physician preference. Identification of predictive factors, and of optimal treatment may lead to improved outcomes. Purpose: To identify predictive factors for the development of acute hypertensive crisis and to develop best treatment pathways. Framework: A retrospective chart review of 97 adult patients receiving MUD-HPC infusions from October 2003 - September 2004 was done. Methods: A retrospective chart review of 97 consecutive patients receiving MUD HPC infusions was completed. Demographic, clinical and laboratory factors were evaluated for the occurrence of hypertensive crisis using regression analysis. This analysis was limited to patients receiving HPC-marrow because only 2 of 20 cases occurred among patients receiving peripheral blood stem cell infusions. Hypertension crisis was defined as SBP >160, DBP >100 or a symptomatic increases in BP of 20 mm HG > baseline. Findings: On univariate analysis, volume infused (adjusted for weight), elevated creatinine (>1.0mg/dl) and BUN levels above the median (>15mg/dl) were significant predictors. Because of high correlation between BUN and creatinine, only BUN was considered in multivariate analysis (higher precision associated with the estimate). Patients receiving high volume infusions with an elevated BUN were at the greatest risk (62%), followed by patients receiving high volume infusions and low BUN (28%), and then by patients receiving low volume and high BUN (17%). There were no cases of hypertension among the 18 patients who received low volumes and had a low BUN. Medical treatment during hypertensive episodes varied by best responses was seen with combined use of IV antihypertensive agents and diuretics. These findings suggest that volume reduction of HPC-M may decrease the incidence of acute hypertensive crisis during MUD infusions.en_GB
dc.date.available2011-10-27T12:05:04Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:05:04Z-
dc.conference.date2006en_US
dc.conference.name31st Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationBoston, Massachusetts, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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