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Transfusion-Associated Circulatory Overload: Evidence-Based Strategies to Prevent, Identify, and Manage a Serious
Elizabeth A Henneman1, Chester Andrzejewski2, Anna Gawlinski2
1Elizabeth A. Henneman is an associate professor, College of Nursing, University of Massachusetts Amherst, Massachusetts. Chester Andrzejewski Jr is medical director, System Transfusion Medicine Services, Baystate Health, Springfield, Massachusetts. Anna Gawlinski is an adjunct professor, UCLA School of Nursing, Los Angeles, California. Kelley McAfee is a doctoral student, College of Nursing, University of Massachusetts Amherst, Massachusetts. Thomas Panaccione is a nurse manager, Observation and Infusion Services, Baystate Health, Springfield, Massachusetts. Kimberly Dziel is a nurse manager, Baystate Health, Springfield, Massachusetts. henneman@nursing.umass.edu.
Abstract:
Transfusion-associated circulatory overload (TACO) is a potentially life-threatening complication of blood transfusion and is associated with increased morbidity, length of stay (hospital and intensive care unit), and hospital costs. Bedside nurses play a key role in the prevention, identification, and reporting of this complication. A common misperception is that the most frequently encountered serious adverse event during transfusion is a hemolytic reaction in a patient who receives ABO-incompatible blood. In fact, the incidence of TACO-related fatalities is higher than fatalities caused by ABO-related hemolytic reactions. Surveillance and evidence-based strategies such as clinical decision support systems have the potential to reduce the incidence of TACO and mitigate its effects. Practical suggestions for conducting bedside transfusion surveillance and future directions for improving transfusion care are presented.
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