II. Epidemiology

  1. Incidence: 1 to 8% of transfusions
  2. Leading cause of transfusion-associated mortality

III. Pathophysiology

  1. Blood Product transfusion volume results in cardiogenic pulmonary edema
  2. Each unit of Blood Product ranges from 150 to 300 ml and initially, most of this remains intravascular
  3. Infused volumes may be large when multiple units are transfused

IV. Risk Factors

  1. Cardiomyopathy or chronic Congestive Heart Failure
  2. Chronic Kidney Disease
  3. Compensated Anemia
  4. Baseline volume overload
  5. Cancer
  6. Anticoagulation reversal with plasma
  7. Very young (infants) and elderly

V. Differential Diagnosis

VI. Signs

  1. Fever
  2. Dyspnea
  3. Tachypnea
  4. Tachycardia
  5. Hypoxemia
  6. Hypertension
  7. Cardiogenic pulmonary edema related findings (distinguishes TACO from TRALI)
    1. Peripheral Edema
    2. Jugular Venous Distention

VII. Imaging: Chest XRay

VIII. Labs

  1. NT-BNP elevated
    1. Contrast with normal level in TRALI

IX. Management

  1. Manage as acute Cardiogenic Shock
  2. Supportive Care

X. Prevention

  1. Slow transfusion to >4 hours
  2. Decrease transfusion volume

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Related Studies

Ontology: Transfusion-related circulatory overload (C1739101)

Concepts Sign or Symptom (T184)
English Transfusion-related circulatory overload
Dutch transfusiegerelateerde circulatoire 'overload'
French Surcharge circulatoire liée à la transfusion
German Transfusionsbedingte Ueberladung des Kreislaufsystems
Italian Sovraccarico circolatorio da trasfusione
Portuguese Sobrecarga circulatória relacionada com transfusão
Spanish Sobrecarga circulatoria post-transfusional
Japanese 輸血に伴う循環過負荷, ユケツニトモナウジュンカンカフカ
Czech Přetížení oběhového systému souvisící s trasfúzí
Hungarian Transzfúzióval összefüggő keringés túlterhelés