Transfusion associated circulatory overload

Case contributed by Daniel Hyeong Seok Kim , 22 Aug 2022
Diagnosis certain
Changed by Calum Worsley, 30 Aug 2022
Disclosures - updated 12 Apr 2022: Nothing to disclose

Updates to Case Attributes

Title was changed:
Transfusion Associated Circulatory Overload-associated circulatory overload (TACO)
Status changed from pending review to published (public).
Published At was set to .
Age changed from 60 to 60 years.
Presentation was changed:
Sudden onset of SOBshortness of breath and tachypnea status post transfusion.
Body was changed:

Patients presenting with SOBshortness of breath and tachypnoea immediately after transfusion should increase suspicion of pulmonary complications. With signs of increased pulmonary venous hydrostatic pressure such as pulmonary oedema and pleural effusion, this case is most consistent with transfusion-associated circulatory overload (TACO). Patients who develop TACO have increased susceptibility to volume overload due to heart failure, renal dysfunction, hypoalbuminaemia, or positive fluid balance.

This case was submitted with supervision and input from:Soni C. Chawla, M.D.Health Sciences Clinical Professor,Department of Radiological Sciences,David Geffen School of Medicine at UCLA.Attending Radiologist,Olive View - UCLA Medical Centre.

  • -<p>Patients presenting with SOB and tachypnoea immediately after transfusion should increase suspicion of pulmonary complications. With signs of increased pulmonary venous hydrostatic pressure such as pulmonary oedema and pleural effusion, this case is most consistent with transfusion-associated circulatory overload (TACO). Patients who develop TACO have increased susceptibility to volume overload due to heart failure, renal dysfunction, hypoalbuminaemia, or positive fluid balance.</p><p> </p><p><em>This case was submitted with supervision and input from:<br>Soni C. Chawla, M.D.<br>Health Sciences Clinical Professor,<br>Department of Radiological Sciences,<br>David Geffen School of Medicine at UCLA.<br>Attending Radiologist,<br>Olive View - UCLA Medical Centre.</em></p>
  • +<p>Patients presenting with shortness of breath and tachypnoea immediately after transfusion should increase suspicion of pulmonary complications. With signs of increased pulmonary venous hydrostatic pressure such as pulmonary oedema and pleural effusion, this case is most consistent with transfusion-associated circulatory overload (TACO). Patients who develop TACO have increased susceptibility to volume overload due to heart failure, renal dysfunction, hypoalbuminaemia, or positive fluid balance.</p><p> </p><p><em>This case was submitted with supervision and input from:<br>Soni C. Chawla, M.D.<br>Health Sciences Clinical Professor,<br>Department of Radiological Sciences,<br>David Geffen School of Medicine at UCLA.<br>Attending Radiologist,<br>Olive View - UCLA Medical Centre.</em></p>

References changed:

  • Semple J, Rebetz J, Kapur R. Transfusion-Associated Circulatory Overload and Transfusion-Related Acute Lung Injury. Blood. 2019;133(17):1840-53. <a href="https://doi.org/10.1182/blood-2018-10-860809">doi:10.1182/blood-2018-10-860809</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30808638">Pubmed</a>
  • Vlaar A & Veelo D. The First Steps in Understanding of Transfusion-Associated Circulatory Overload-We Are on a "Roll". Crit Care Med. 2018;46(4):650-1. <a href="https://doi.org/10.1097/CCM.0000000000002971">doi:10.1097/CCM.0000000000002971</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29538118">Pubmed</a>
  • Semple JW, Rebetz J, Kapur R. Transfusion-associated circulatory overload and transfusion-related acute lung injury. Blood. 2019 Apr 25;133(17):1840-1853. doi: 10.1182/blood-2018-10-860809. Epub 2019 Feb 26. PMID: 30808638.
  • Vlaar APJ, Veelo DP. The First Steps in Understanding of Transfusion-Associated Circulatory Overload-We Are on a "Roll". Crit Care Med. 2018 Apr;46(4):650-651. doi: 10.1097/CCM.0000000000002971. PMID: 29538118.

Updates to Link Attributes

Title was removed:
Transfusion Associated Circulatory Overload (TACO)
Type was removed.
Visible was set to .

Updates to Link Attributes

Updates to Study Attributes

Findings was changed:

Moderate diffuse bilateral pulmonary vascular congestion and interstitial edema with diffuse bronchial wall thickening and Kerley B lines mainly in the mid and lower lung zones are compatible with pulmonary edema from transfusion associated circulatory overload givenhistory of transfusion.

No discrete large effusion or pneumothorax. No discrete focal pneumonia.

Heart appears at upper limits normal with mild diffuse prominence of the main PApulmonary artery.

No acute osseous findings. No free air in the upper abdomen. 

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