Daurat et al identified risk factors for transfusion-associated circulatory overload (TACO). These can help to identify a patient who may benefit from more aggressive monitoring and management. The authors are from Centre Hospitalier Universitaire de Nimes in France.
Patient selection: TACO
Risk factors:
(1) chronic use of loop diuretics (odds ratio 6.5)
(2) hemorrhagic shock (odds ratio 12)
(3) body weight < 46 kilograms (odds ratio 7.9)
(4) chronic hypertension (odds ratio 4.1)
where:
• Chronic use of loop diuretics suggests chronic kidney disease with reduced ability to excrete a fluid load.
• Chronic hypertension suggests hypertensive heart disease.
• A low body weight would be associated with a small blood volume.
• In hemorrhagic shock a lot of fluid is pushed intravenously over a short period of time.
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The risk would increase with the number of risk factors, but most patients might have only one or two.
