{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:46:22Z","timestamp":1778697982449,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Consensus definitions for transfusion\u2010related acute lung injury (TRALI) and transfusion\u2010associated circulatory overload (TACO) have recently been revised; however, pulmonary transfusion reactions remain difficult to diagnose. We hypothesized that N\u2010terminal pro\u2010brain natriuretic peptide (NT\u2010proBNP) levels could have utility in the identification and classification of pulmonary transfusion reactions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design and methods<\/jats:title><jats:p>We performed a secondary analysis of a case\u2010control study of pulmonary transfusion reactions at four academic hospitals. We evaluated clinical data and measured NT\u2010proBNP levels prior to and following transfusion in patients with TACO (n = 160), transfused acute respiratory distress syndrome (ARDS) [n = 51], TRALI [n = 12], TACO\/TRALI [n = 7], and controls [n = 335]. We used Wilcoxon Rank\u2010Sum tests to compare NT\u2010proBNP levels, and classification and regression tree (CART) algorithms to produce a ranking of covariates in order of relative importance for differentiating TACO from transfused controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pre\u2010transfusion NT\u2010proBNP levels were elevated in cases of transfused ARDS and TACO (both <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) but not TRALI (<jats:italic>P<\/jats:italic> = .31) or TACO\/TRALI (<jats:italic>P<\/jats:italic> = .23) compared to transfused controls. Pre\u2010transfusion NT\u2010proBNP levels were higher in cases of transfused ARDS or TRALI with a diagnosis of sepsis compared to those without (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05 for both). CART analyses resulted in similar differentiation of patients with TACO from transfused controls for models utilizing either NT\u2010proBNP levels (AUC 0.83) or echocardiogram results (AUC 0.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>NT\u2010proBNP levels may have utility in the classification of pulmonary transfusion reactions. Prospective studies are needed to test the predictive utility of pre\u2010transfusion NT\u2010proBNP in conjunction with other clinical factors in identifying patients at risk of pulmonary transfusion reactions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16059","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T12:01:45Z","timestamp":1601208105000},"page":"2548-2556","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["<scp>NT\u2010proBNP<\/scp> levels in the identification and classification of pulmonary transfusion reactions"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1063-6155","authenticated-orcid":false,"given":"Nareg H.","family":"Roubinian","sequence":"first","affiliation":[{"name":"Kaiser Permanente Division of Research  Oakland California USA"},{"name":"Vitalant Research Institute  San Francisco California USA"},{"name":"University 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