TY - JOUR T1 - A retrospective review of patient factors, transfusion practices, and outcomes in patients with transfusion-associated circulatory overload. JF - Transfusion medicine reviews//Transfus Med Rev Y1 - 2013 A1 - Lieberman, Lani A1 - Maskens, Carolyn A1 - Cserti-Gazdewich, Christine A1 - Hansen, Mark A1 - Lin, Yulia A1 - Pendergrast, Jacob A1 - Yi, Qi Long A1 - Callum, Jeannie KW - *Blood Transfusion/ae [Adverse Effects] KW - *Blood Transfusion/mt [Methods] KW - Adult KW - Aged KW - Colloids/tu [Therapeutic Use] KW - Cyanosis/et [Etiology] KW - Databases, Factual KW - Dyspnea/et [Etiology] KW - Echocardiography KW - Female KW - Heart Failure/co [Complications] KW - Heart Failure/et [Etiology] KW - Humans KW - Hypertension/et [Etiology] KW - Kidney Diseases/co [Complications] KW - Male KW - Medical Records KW - Middle Aged KW - Multicenter Studies as Topic KW - Ontario KW - Retrospective Studies KW - Risk Factors KW - Young Adult AB - Transfusion-associated circulatory overload (TACO) is a common yet underrecognized and underreported complication of transfusion associated with significant morbidity and mortality. The objective of this study was to examine patient and transfusion characteristics in a cohort of TACO cases. A retrospective medical record review of 100 consecutive TACO episodes reported at 2 academic centers was performed. Information related to demographics, medical history, radiologic and echocardiographic investigations, infusion practices, reaction features, management, and outcome were collected. Ninety-eight cases were accessible for review. A history of congestive heart failure (41%), renal dysfunction (44%), and age more than 70 years (56%) were common in TACO patients. Suboptimal fluid status management and inappropriate infusion practices were often seen (eg, verbal orders, double red cell transfusions, rapid infusion rates, lack or improper timing of preemptive diuretics). The median volume of blood ordered was 500 mL, and the median volume of crystalloid or colloid (preceding 24 hours) was 2200 mL. A physician order specifying the infusion rate was documented in 50% of transfusion orders. Preemptive diuretics were ordered in only 29% of cases, most commonly introduced midway or after the transfusion at a dose of furosemide 20 mg intravenously. After TACO, 18% of patients required transfer to the intensive care unit, 8% suffered a major complication, and 2% died. Suboptimal ordering and infusion practices may be contributing to the high incidence and severity of TACO. Research in TACO prevention strategies, such as slow rates of infusion and preemptive diuretics, is warranted. Copyright © 2013. M1 - be5, 8709027 PB - Lieberman,Lani. Department of Clinical Pathology, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada. CY - United States VL - 27 SN - 1532-9496 CP - 4 L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=24075097 ID - 4171 ER -