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Transfusion-associated circulatory overload — SCE Acute Medicine MCQ

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HardPatient safety and risk managementTransfusion-associated circulatory overloadSCE Acute Medicine

A 74-year-old woman receives two units of red cells for GI bleeding. During the second unit she becomes acutely breathless and hypertensive with raised JVP and bibasal crackles. Oxygen saturation is 86% and chest radiograph shows pulmonary oedema; temperature is normal. What is the most likely diagnosis?

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Correct answer: C — Transfusion-associated circulatory overload

Hypertension, raised JVP and pulmonary oedema during transfusion in an older patient favour transfusion-associated circulatory overload. TRALI usually causes non-cardiogenic pulmonary oedema with hypotension and fever more commonly. The transfusion should be stopped and the transfusion laboratory informed while supportive treatment is given.

Reference: https://b-s-h.org.uk/guidelines#acute-medicine-order-89-1