TACO (Transfusion Associated Circulatory Overload)

Record number: 
MPHO Type: 
Estimated frequency: 
TACO associated with renal failure (OR 27.0), past H/O heart failure (OR 6.6), hemorrhagic shock (OR 113), number of products transfused (OR 1.1 per unit), fluid blance per hour (9.4 per liter), and increased in-hospital mortality HR 3.2). 
Time to detection: 
<6 hours
Alerting signals, symptoms, evidence of occurrence: 
Hypoxia on blood gas determination. Case control design (83 patients at UCSF and Mayo). 
Demonstration of imputability or root cause: 
CDC Biovigilance criteria for TACO cases (pulmonary edema within 6 hours of transfusion), reviewed by three experts. Hypoxia based on blood gases identified eligible subjects.
Suggest references: 
Murphy EL, Kwaan N, Looney MR, Gajic O, Hubmayr RD, Gropper MA, Koenigsberg M, Wilson G, Matthay M, Bacchetti P, Toy P, TRALI Study Group.  Risk factors and outcomes in transfusion-associated circulatory overload. Am J Med 2013;126:357-