Authors: Nareg Roubinian, M.D., M.P.H.T.M. et al
Anesthesiology 3 2017, Vol.126, 363-365.
TRANSFUSION-ASSOCIATED circulatory overload (TACO) remains the most common pulmonary complication of transfusion and the second most common cause of transfusion-related deaths reported to the Food and Drug Administration. The term TACO was coined by Popovsky in 1983 and is characterized by new or worsening hydrostatic pulmonary edema occurring within 6 h of blood transfusion. Its incidence, especially in perioperative settings where approximately one quarter of blood components is transfused, has historically been underestimated due to passive reporting. However, with the advent of electronic health records, we have seen advances in algorithms to screen and identify cases of posttransfusion pulmonary edema. Toy et al. pioneered such algorithms in their study of transfusion-related acute lung injury at the University of California San Francisco (San Francisco, California), and the Mayo Clinic group has used them to study the epidemiology of pulmonary transfusion reactions. In this issue, Clifford et al. characterize risk factors and associated outcomes related to perioperative TACO.