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Transfusion-associated circulatory overload
From WikEM
(Redirected from TACO)
Contents
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
- 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
Acute allergic reaction
- Allergic reaction/urticaria
- Anaphylaxis
- Angioedema
- Asthma exacerbation
- Anxiety attack
- Scombroid
- Cold urticaria
- Contrast induced allergic reaction
- Shock
- Transfusion reaction
- Carcinoid syndrome
Evaluation
- BNP or NT-proBNP to differentiate from other lung injury
Management
- Treat like normal CHF exacerbation
- Supportive care
- O2 and possibly BiPAP
- Diuretics