At some point in our lives, due to an accident, surgery, or some medical condition, we or a loved one may need to receive a blood transfusion. This is a very important medical procedure that can save lives. However, although it is safe in most cases, very rarely, complications can occur due to this blood transfusion . Today we are talking about a condition that is a bit serious, but one that we all need to be aware of. That is TACO, or in medical terms `Transfusion-Associated Circulatory Overload`.
What exactly is TACO?
Simply put, TACO is when the amount of fluid in your body's circulatory system suddenly increases after donating blood, and you can't handle it. Think of it like a water tank suddenly overflowing with water.
When we donate blood, some fluid is added to our blood vessels. Normally, our heart and kidneys can manage this extra fluid well and keep the body in balance. But sometimes, especially if you donate too much blood at once, or if your heart or kidneys are weak, this extra fluid cannot be handled. Then, the pressure in the blood vessels increases, and fluid starts to leak into organs like the lungs . This makes it difficult to breathe, the body swells, and blood pressure increases unimaginably. This is a very serious condition , so it is essential to seek medical attention immediately if symptoms appear.
What are the symptoms of this condition?
Symptoms of TACO can appear at any time during or within 12 hours of donating blood. Therefore, we should be very careful about a person who has donated blood during this period. The main symptoms are explained in the table below.
| Symptom | Description |
|---|---|
| Difficulty breathing (Dyspnea) | This is the main and most common symptom. The lungs fill with fluid, making it difficult to breathe. This can be especially bad when lying down. |
| Cough | Sometimes a cough may occur with pink, frothy mucus. |
| Chest pain | You may feel chest tightness or pain as the heart is working harder. |
| Blue color of the skin, lips, or nails (Cyanosis) | This can happen when the body doesn't get enough oxygen. This is a serious symptom. |
| Swelling of the legs, ankles, or neck | This swelling is caused by fluid retention in the body. The veins in the neck may also appear bulging. |
| Rapid heartbeat (Tachycardia) | The heart beats faster because the heart has to work harder to pump blood throughout the body. |
| Dizziness or loss of consciousness | This condition can occur due to a decrease in the amount of oxygen reaching the brain. |
| Severe headache | Another symptom that can occur due to high blood pressure. |
The most important thing is, if you notice any of these symptoms, don't ignore them. If you are in the hospital, notify a nurse or doctor immediately. If you are at home, go to the nearest hospital's Emergency Department (ETU) immediately.
Who is more at risk?
Although TACO can affect anyone, some people are at higher risk. If any of these conditions apply to you or someone you know, it is important to talk to your doctor before donating blood.
| Risk factor | A brief explanation |
|---|---|
| Over 60 years of age | As we age, the function of the heart and kidneys may naturally decrease slightly. |
| Having a history of heart disease | People with conditions such as myocardial infarction or heart failure are at higher risk. |
| Having kidney disease | If the kidneys, which are the main organs that control the amount of fluid in the body, are weak, it becomes difficult to remove excess fluid. |
| Respiratory diseases such as COPD | For those who already have some kind of lung weakness, such as Chronic Obstructive Pulmonary Disease (COPD), it can be difficult to cope with fluid filling the lungs. |
| Use of certain medications | If you have recently used medicines that increase blood pressure (Vasopressors) or medicines that remove fluid from the body (Loop Diuretics). |
| Having donated blood several times before | The risk may also be slightly increased for those who receive frequent blood transfusions. |
How does a doctor recognize and treat this?
If you develop symptoms of TACO, the first thing your doctor will do is examine you carefully and ask about your symptoms. They will listen to your breathing and measure your blood pressure.
Then, to confirm the diagnosis, you may be referred for tests such as:
- Chest X- ray: This can check for fluid in the lungs.
- Blood tests : Certain enzyme levels are checked to see if there is any damage to the heart.
- Echocardiogram: This can provide a clear picture of the heart's function and pumping.
As a treatment, your blood supply is stopped immediately. You are then sedated and placed on a bed to help you breathe. The main treatment is diuretics, which are medicines that remove excess fluid from the body. These increase urine output and help control fluid levels in the body .
If breathing becomes difficult, oxygen therapy may be necessary. In very serious cases, the patient may need to be connected to an artificial breathing machine (Mechanical Ventilation).
Are there ways to prevent this?
Yes, this can be prevented to some extent. If you belong to one of the risk groups mentioned above, a doctor will take special care when deciding to give you blood.
- Reducing the rate of blood transfusion: To prevent a large amount of fluid from entering the body at once, the rate of blood transfusion is greatly reduced.
- Giving Diuretics Before Treatment: Before donating blood, medications may be given to remove excess fluid from the body.
- Blood donation: Instead of giving the entire amount of blood at once, you can give it in small amounts, divided into two doses per day.
It is your responsibility to tell your doctor your complete medical history (especially heart and kidney problems) without hiding anything. If you have had any discomfort during a previous blood donation, be sure to mention that as well.
Donating blood is a life-saving thing. TACO is a rare condition. But being aware of it can help you recognize symptoms and seek treatment quickly if they occur.
Take-Home Message
- TACO is a serious, but rare, complication that can occur from blood donation.
- Difficulty breathing, coughing, swelling, and chest pain are the main warning signs.
- This risk is higher in older people with heart, kidney, or lung disease.
- If you experience any of these symptoms while donating blood or within 12 hours of donating, immediately notify the medical staff or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
- Before donating blood, be sure to tell your doctor about your complete medical history and any complications you have experienced during previous blood donations.
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