Augustina Isioma Ikusemoro: Understanding One of the Most Common and Preventable Transfusion Reactions
Augustina Isioma Ikusemoro, Hematology and Transfusion Medicine Specialist at Sharjah Blood Transfusion and Research Center, shared a post on LinkedIn:
“Too much blood can be just as dangerous as too little.
Not every transfusion complication is immune-mediated. Sometimes, the problem is simply… too much volume, too fast.
TACO (Transfusion-Associated Circulatory Overload) is one of the most common and preventable serious transfusion reactions — yet it is still under-recognized in clinical
practice.
What causes TACO?
When transfused volume exceeds the patient’s cardiovascular capacity to tolerate it.
Common triggers include:
- Rapid transfusion rates
- Large-volume transfusions
- Multiple blood products in a short time
- Poor assessment of cardiac or renal reserve
What happens pathophysiologically?
- Excess intravascular volume
- Increased hydrostatic pressure
- Fluid shifts into the lungs
- Pulmonary edema
- Respiratory distress and hypoxemia
How does the patient present?
- Sudden dyspnea
- Tachypnea
- Hypertension
- Tachycardia
- Raised JVP
- Pulmonary crackles
- Pink frothy sputum in severe cases
Who is at higher risk?
- Elderly patients
- Cardiac disease
- Renal impairment
- Neonates and pediatrics
- Patients receiving large-volume or rapid transfusions
The most important message?
TACO is often preventable.
Slow the rate.
Assess the risk.
Calculate the volume.
Monitor closely.
Because in transfusion medicine:
We give blood — not volume.
Small volume. Slow rate. Close monitoring. Better outcomes.
-Signature of Blood Doki
Educate. Empower. Elevate.
Better Blood.
Better Care.
Better Outcomes.”
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