Transfusion-associated circulatory overload: Difference between revisions
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==Background== | ==Background== | ||
*Often confused with [[TRALI]] | *Often confused with [[TRALI]] | ||
*Frequently with rapid admin and large volume transfusions | *Frequently with rapid admin and large volume [[transfusions]] | ||
*Associated with a rapid rise in blood pressure, not hypotension | *Associated with a rapid '''[[hypertension|rise]]''' in blood pressure, ''not'' hypotension | ||
*Essentially a CHF exacerbation 2/2 increased volume | *Essentially a [[CHF]] exacerbation 2/2 increased volume | ||
{{TRALI vs TACO}} | {{TRALI vs TACO}} | ||
==Clinical Features== | ==Clinical Features== | ||
*Dyspnea, orthopnea, peripheral edema, rapid rise in BP | *[[Dyspnea]], orthopnea, peripheral edema, [[hypertension|rapid rise]] in BP | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 19: | Line 19: | ||
==Management== | ==Management== | ||
*Treat like normal CHF exacerbation | *Treat like normal [[CHF]] exacerbation | ||
**Supportive care | **Supportive care | ||
**O2 and possibly [[BiPAP]] | **[[O2]] and possibly [[BiPAP]] | ||
**Diuretics | **[[Diuretics]] | ||
==Disposition== | ==Disposition== | ||
Latest revision as of 18:54, 1 October 2019
Background
- Often confused with TRALI
- Frequently with rapid admin and large volume transfusions
- Associated with a rapid rise in blood pressure, not hypotension
- Essentially a CHF exacerbation 2/2 increased volume
TRALI vs TACO
| TRALI | TACO | |
| Onset | Acute, within 6hrs | Often more gradual |
| BP | Low | High |
| Temp | Febrile | Normal |
| JVD/pedal edema | Unlikely | Likely |
| CVP/PAWP | Normal | Elevated |
| BNP | Normal | Elevated |
| Resp | Dyspneic | Dyspneic |
| CXR | B/l infiltrates | B/l infiltrates |
Clinical Features
- Dyspnea, orthopnea, peripheral edema, rapid rise in BP
Differential Diagnosis
Transfusion Reaction Types
- Acute
- Delayed
Acute allergic reaction
- Allergic reaction/urticaria
- Anaphylaxis
- Angioedema
- Anxiety attack
- Asthma exacerbation
- Carcinoid syndrome
- Cold urticaria
- Contrast induced allergic reaction
- Scombroid
- Shock
- Transfusion reaction
Evaluation
- BNP or NT-proBNP to differentiate from other lung injury