title: 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 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.
authors: Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Asim
authors: A
authors: Alam
authors: Yulia
authors: Y
authors: Lin
authors: Ana
authors: A
authors: Lima
authors: Mark
authors: M
authors: Hansen
authors: Jeannie L
authors: JL
authors: Callum
mesh_terms: D000367:Age Factors; D001775:Blood Circulation / Q000502:physiology*; D001803:Blood Transfusion / Q000379:methods / Q000451:nursing / Q000706:statistics & numerical data; D003422:Critical Care / Q000379:methods; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D011654:Pulmonary Edema / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology* / Q000517:prevention & control; D012307:Risk Factors; D065227:Transfusion Reaction; D014882:Water-Electrolyte Balance / Q000502:physiology