Key result
TACO is linked to pre-transfusion tachycardia, fever, and moderate-to-severe hypertension followed by blood pressure drops.
Why the study?
Transfusion-associated circulatory overload is a transfusion-related heart failure condition with patient-specific precipitating factors, warranting an analysis of clinical courses focusing on blood pressure elevation as a volume overload sign.
Observational (n=5)
No
Careful monitoring of vital signs, including pulse and temperature, for at least 6 hours is crucial for early detection of transfusion-associated circulatory overload, especially in elderly patients with underlying heart disease.
May support close vital sign monitoring in transfusion recipients; leaves open prospective validation of these TACO predictors.
輸血関連循環過負荷Transfusion associated circulatory overload（以下TACO）は輸血に関連する心不全状態であり，TACOの発症要因は患者ごとに異なる．今回，当院で遭遇したTACO症例を含め，TACO診断における容量負荷所見の一つである血圧上昇に着目し臨床経過の特徴について解析した．血圧上昇症例では，TACOの危険因子を有する患者は中等症～重症の高血圧を示す傾向がみられた．TACO症例では，80歳以上の高齢で心疾患を有している患者の血圧上昇は軽度にとどまり，後に低血圧となる傾向がみられた．また，輸血開始前より頻脈傾向を示した患者が多く，このような患者では特に注意深い経過観察が重要であることが示唆された．さらには肺炎や敗血症を罹患している患者では血圧上昇もしくは脈拍上昇に加え発症時に発熱がみられていた点から，発熱も注意すべき徴候と考えられた．発症時間は輸血開始30分後から5時間30分後と範囲が広く，危険因子を有する患者に対しては，輸血副作用の管理を綿密かつ6時間以上は行うべきと考えられた．
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Kamakura et al. (2018) conducted an observational in Transfusion Associated Circulatory Overload (TACO) (n=5). Blood transfusion was evaluated on Clinical features of TACO (blood pressure, pulse, fever). Patients who developed transfusion-associated circulatory overload (TACO) frequently exhibited moderate to severe hypertension followed by a decrease in blood pressure, along with pre-transfusion tachycardia and fever.
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