Our patient has deteriorated towards the end of a two unit transfusion. He is short of breath and more hypoxic compared to previous. Observations are below:
|Before unit one||Towards end unit two|
|Oxygen saturations||97% RA||91% RA|
A chest radiograph is obtained (AP)
TeamHaem followers are concerned about transfusion associated circulatory overload (TACO) and transfusion-associated lung injury (TRALI). He is given oxygen and once sitting up feels better. He tells you he’s never had any heart problems before. His main problem is that his clothes no longer fit him due to weight loss.
- What are the risk factors for TRALI and TACO?
- Is there a way to differentiate between the two?
- How is TACO managed?
- How is TRALI investigated?
Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to evolve over the coming week so keep checking #TeamHaem on Twitter for more information.
Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.
TeamHaem are not a position of authority. It is an educational platform to allow discussion and learning.