//fpnotebook.com/
Transfusion Associated Circulatory Overload
Aka: Transfusion Associated Circulatory Overload, Transfusion Related Circulatory Overload, TACO
- See Also
- Transfusion Complication
- Transfusion-Related Acute Lung Injury (TRALI)
- Epidemiology
- Incidence: 1 to 8% of transfusions
- Leading cause of transfusion-associated mortality
- Pathophysiology
- Blood Product transfusion volume results in Cardiogenic Pulmonary Edema
- Each unit of Blood Product ranges from 150 to 300 ml and initially, most of this remains intravascular
- Infused volumes may be large when multiple units are transfused
- Risk Factors
- Cardiomyopathy or chronic Congestive Heart Failure
- Chronic Kidney Disease
- Compensated Anemia
- Baseline volume overload
- Cancer
- Anticoagulation reversal with plasma
- Very young (infants) and elderly
- Differential Diagnosis
- Transfusion-Related Acute Lung Injury (TRALI)
- Signs
- Fever
- Dyspnea
- Tachypnea
- Tachycardia
- Hypoxemia
- Hypertension
- Cardiogenic Pulmonary Edema related findings (distinguishes TACO from TRALI)
- Peripheral Edema
- Jugular Venous Distention
- Imaging: Chest XRay
- Bilateral Pulmonary Infiltrates
- Labs
- NT-BNP elevated
- Contrast with normal level in TRALI
- Management
- Manage as acute Cardiogenic Shock
- Supportive Care
- Prevention
- Slow transfusion to >4 hours
- Decrease transfusion volume
- References
- Raval (2020) Am Fam Physician 102(1):30-8 [PubMed]