Transfusion-associated circulatory overload

Background

• Often confused with TRALI
• Frequently with rapid admin and large volume transfusions
• Associated with a rapid rise in blood pressure, not hypotension

Clinical Features

• Dyspnea, orthopnea, peripheral edema, rapid rise in BP

Differential Diagnosis

Transfusion Reaction Types

• Acute
  • Intravascular hemolytic tranfusion reaction
  • Febrile nonhemolytic tranfusion reaction
  • Allergic tranfusion reaction
  • Transfusion-associated circulatory overload (TACO)
  • Transfusion-related acute lung injury (TRALI)
  • Transfusion-associated graft-versus-host disease
  • Fluid overload
  • Sepsis
• Delayed
  • Extravascular hemolytic tranfusion reaction
  • Graft-vs-host disease
  • Transfusion infections

Acute allergic reaction

• Allergic reaction/urticaria
• Anaphylaxis
• Angioedema
• Anxiety attack
• Asthma exacerbation
• Carcinoid syndrome
• Cold urticaria
• Contrast induced allergic reaction
• Scombroid
• Shock
• Transfusion reaction

Diagnosis

• BNP or NT-proBNP to differentiate from other lung injury

Management

• O2,
• Supportive care
• Diuretics

See Also

• Transfusion reaction