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Transfusion Associated Circulatory Overload

  • Chapter
  • First Online:
Hematologic Abnormalities and Acute Lung Syndromes

Part of the book series: Respiratory Medicine ((RM))

  • 847 Accesses

Search Terms

MeSH terms

Number

Transfusion

E02.095.135

Pulmonary edema

C08.381.742

Diuresis

G08.852.796.241

Erythrocyte transfusion

E02.095.135.140.275

Plasma

A12.207.152.693

Circulatory and respiratory physiological phenomena

G09

Pleural effusion

C08.528.652

Heart failure

C14.280.434

Acute lung injury

C08.381.520.500

Hypoxemia

C23.888.852.079

Hemorrhage

C23.550.414

Abstract

Transfusion Associated Circulatory Overload (TACO) is the most common pulmonary adverse event associated with transfusion. TACO, which is likely underreported, has significant associated morbidity and mortality. Its clinical features include new onset respiratory distress, hypoxemia, orthopnea, and/or cough during or after blood transfusion. Diagnosis includes new onset or worsening respiratory distress, left heart failure, positive fluid balance, or pulmonary edema on chest radiograph. Prevention with concurrent diuretics, slower transfusion speed and smaller transfusion volumes should be considered. Initial goals of management include support of airway, breathing, circulation, and cessation of the transfusion. Supplemental oxygen, noninvasive or invasive ventilation should be considered. The mainstay of therapy is volume reduction including diuretics or ultrafiltration/dialysis, if needed. In patients with systolic dysfunction, preload and afterload reduction should be initiated. As TACO is associated worsened outcomes, providers must be cognizant of those at risk in order to recognize it and respond promptly when it occurs.

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Author information

Authors and Affiliations

  1. Division of Telehealth, Division of Pulmonary and Critical Care Medicine, Westchester Medical Center, Valhalla, NY, USA

    Mario V. Fusaro MD

  2. Division of Pulmonary and Critical Care Medicine, Department of Medicine, and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA

    Mario V. Fusaro MD & Giora Netzer MD, MSCE

Authors
  1. Mario V. Fusaro MD
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  2. Giora Netzer MD, MSCE
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Correspondence to Giora Netzer MD, MSCE .

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Editors and Affiliations

  1. Division of Pulmonary, Allergy, and Critical Care Medicine Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Janet S. Lee

  2. Division of Pulmonary, Allergy, and Critical Care Medicine Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Michael P. Donahoe

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Fusaro, M.V., Netzer, G. (2017). Transfusion Associated Circulatory Overload. In: Lee, J., Donahoe, M. (eds) Hematologic Abnormalities and Acute Lung Syndromes. Respiratory Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-41912-1_12

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  • DOI: https://doi.org/10.1007/978-3-319-41912-1_12

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  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-41910-7

  • Online ISBN: 978-3-319-41912-1

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