Hematology and Oncology Book


Transfusion Associated Circulatory Overload

Aka: Transfusion Associated Circulatory Overload, Transfusion Related Circulatory Overload, TACO
  1. See Also
    1. Transfusion Complication
    2. Transfusion-Related Acute Lung Injury (TRALI)
  2. Epidemiology
    1. Incidence: 1 to 8% of transfusions
    2. Leading cause of transfusion-associated mortality
  3. 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
  4. 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
  5. Differential Diagnosis
    1. Transfusion-Related Acute Lung Injury (TRALI)
  6. 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
  7. Imaging: Chest XRay
    1. Bilateral Pulmonary Infiltrates
  8. Labs
    1. NT-BNP elevated
      1. Contrast with normal level in TRALI
  9. Management
    1. Manage as acute Cardiogenic Shock
    2. Supportive Care
  10. Prevention
    1. Slow transfusion to >4 hours
    2. Decrease transfusion volume
  11. References
    1. Raval (2020) Am Fam Physician 102(1):30-8 [PubMed]

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
Derived from the NIH UMLS (Unified Medical Language System)

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