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
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 allergic reaction

Evaluation

BNP or NT-proBNP to differentiate from other lung injury

Management

Treat like normal CHF exacerbation
- Supportive care
- O2 and possibly BiPAP
- Diuretics

Disposition

See Also

Transfusion reaction

External Links

References

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