Question

Describe the clinical features of transfusion reactions caused by circulatory overload and patients at risk of this transfusion reaction.

Answer 1

Reactions to blood component transfusion can range from mild to potentially fatal. Transfusion-associated circulatory overload (TACO) is a common transfusion reaction (Acute type Reaction) caused by circulatory overloading in which pulmonary edema develops primarily due to volume excess or circulatory overload. TACO typically occurs in patients who receive a large volume of a transfused product over a short period of time, or in those with underlying cardiovascular or renal disease.

Following clinical features are assosiated with transfusion reaction caused by circulatory overload:-

1. Dyspnea( Difficulty in breathing)

2. Orthopnea(shortness of breathing)

3. Cyanosis (bluish cast of skin and mucous membrane)

4. Hypoxemia(abnormally low concentration of oxygen in the blood)

5. Tachycardia(an abnormally rapid heart rate)

6. Hypertention (high blood pressure)

7. Pulmonary/Pedal edema (swelling in lungs)

8. Elevated JVP(Jugular venous pressure)

The above clinical features appear within 1-2 hours or may upto 6 hours following start of transfusion. In this case transfusion should not be restart and oxygen, diuretics, elevated head to bed are few actions suggested to avoid risk of this transfusion.