Canterbury DHB
This is probably the commonest non-immmunologic complication of blood transfusion. It occurs in 0.1 to 1% of transfusions, usually within 6 hours of transfusion. Risk factors include extremes of age, history of cardiovascular disease, renal dysfunction, large volume transfusions, and rapid transfusion rates. The pathophysiology is that of an acute rise in central venous pressure in the setting of reduced ventricular compliance, leading to pulmonary oedema.
The main differential diagnosis is TRALI (transfusion-related acute lung injury).
Symptoms: Acute shortness of breath/respiratory distress
Signs: tachycardia, hypertension raised JVP, bibasal crepitations. Positive fluid balance is common. A fever is rare.
Serologic investigations are usually negative. BNP is usually elevated. Chest radiograph shows pulmonary congestion.
Note: Report TACO to NZBS.
Topic Code: 644942