The Prevention of Transfusion-Associated Circulatory Overload

Abstract Transfusion-associated circulatory overload (TACO) is an important and potentially injurious complication of transfusion that is underappreciated by clinicians. Risk factors for TACO include being at an extreme of age, having preexisting cardiac and/or (potentially) renal dysfunction, acute...

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Bibliographic Details
Published in:Transfusion medicine reviews 2013-04, Vol.27 (2), p.105-112
Main Authors: Alam, Asim, Lin, Yulia, Lima, Ana, Hansen, Mark, Callum, Jeannie L
Format: Article
Language:English
Subjects:
Age Factors
Blood Circulation - physiology
Blood Transfusion - methods
Blood Transfusion - nursing
Blood Transfusion - statistics & numerical data
Critical Care - methods
Heart Failure - epidemiology
Heart Failure - etiology
Heart Failure - physiopathology
Heart Failure - prevention & control
Hematology, Oncology and Palliative Medicine
Humans
Incidence
Pulmonary Edema - epidemiology
Pulmonary Edema - etiology
Pulmonary Edema - physiopathology
Pulmonary Edema - prevention & control
Risk Factors
Transfusion Reaction
Water-Electrolyte Balance - physiology
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Summary:Abstract Transfusion-associated circulatory overload (TACO) is an important and potentially injurious complication of transfusion that is underappreciated by clinicians. Risk factors for TACO include being at an extreme of age, having preexisting cardiac and/or (potentially) renal dysfunction, acute myocardial infarction, and individuals receiving plasma. Keys to preventing TACO, aside from identifying high-risk individuals, should be multifaceted. We advocate for the widespread use of pretransfusion checklists and implementation of nonemergent transfusion protocols. We suggest the regular use of pretransfusion diuretics in high-risk individuals. When a transfusion is required, we believe that “critical” nursing supervision and leadership are instrumental in the coordination of slow transfusion rates on computerized infusion pumps and ensuring patients are appropriately monitored. We believe that using these methodologies on a global scale will prevent many TACO events and minimize the severity when it does occur.
ISSN:0887-7963
1532-9496
DOI:10.1016/j.tmrv.2013.02.001