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Transfusion associated circulatory overload
Naveen Agnihotri1, Ajju Agnihotri2
1Department of Transfusion Medicine, Fortis Hospital, New Delhi, India.
Summary
Transfusion-associated circulatory overload (TACO) is an underdiagnosed blood transfusion complication. Early suspicion in at-risk patients is crucial for timely management and improved outcomes.
Area of Science:
- Medicine
- Critical Care Medicine
- Hematology
Background:
- Transfusion-associated circulatory overload (TACO) is a recognized complication of blood product administration.
- TACO is frequently underdiagnosed and underreported, potentially due to complex underlying mechanisms.
- Risk factors for TACO include pre-existing cardiovascular or renal conditions.
Observation:
- A 46-year-old patient with diabetes and hypertension developed TACO symptoms after receiving packed red blood cells (RBC) and fresh frozen plasma.
- The complication manifested after a small volume of the fourth RBC unit was transfused.
- The patient required intensive care unit admission for management.
Findings:
- TACO can occur even with relatively small volumes of blood products in susceptible individuals.
- The pathophysiology of TACO is multifactorial and not fully elucidated.
- Clinical presentation includes signs and symptoms indicative of fluid overload and respiratory distress.
Implications:
- Increased clinical suspicion for TACO is warranted in patients receiving blood transfusions, especially those with risk factors.
- Prompt diagnosis and management of TACO can reduce patient morbidity and length of hospital stay.
- Further research into TACO's etiology may improve diagnostic accuracy and preventative strategies.
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