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In transfusion medicine, transfusion-associated circulatory overload (aka TACO) is a transfusion reaction (an adverse effect of blood transfusion) resulting in signs or symptoms of excess fluid in the circulatory system (hypervolemia) within 12 hours after transfusion. [2]
Hypocalcemia is a medical condition characterized by low calcium levels in the blood serum. [5] The normal range of blood calcium is typically between 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), while levels less than 2.1 mmol/L are defined as hypocalcemic. [1] [3] [6] Mildly low levels that develop slowly often have no symptoms.
Transfusion hemosiderosis can cause permanent damage to tissues that may lead to death. [2] Tissue damage can remain even after chelation therapy. [2] Outcomes are usually worse in patients who require blood transfusions compared to those who can have alternative therapies. [2] Cardiomyopathy and cardiac arrhythmia are often a cause of death. [1]
One elderly man with an intestinal bleed died after treatment delays caused by a lack of available A&E beds
Hypocalcemia can also occur with massive blood transfusions because of the complex of citrate with serum calcium. Calcium levels below 0.9 mmol/L should be treated. [73] Blood doping has been used by athletes to increase physical stamina. [74] A lack of knowledge and insufficient experience can turn a blood transfusion into a dangerous event.
Both these phenomena occur in thalassaemias, with blood transfusion therapy being the major cause of iron overload in thalassaemia major and increased GI absorption being more important in patients with intermedia thalassaemia who are not frequently transfused. Each unit of blood contains about 200 mg iron.
As a result, blood can now be stored for much longer, up to 21 days. [4] ACD was developed into CPD (citrate-phosphate-dextrose) in 1957, [5] a version with phosphate added intended to reduce phosphate leakage from red blood cells. It does not improve shelf life appreciably, but patient recovery is improved.
Serious Hazards of Transfusion (SHOT) is the United Kingdom's haemovigilance scheme. It collects and analyses anonymized information on adverse events and blood transfusion reactions. When SHOT has identified risks related to transfusion, it produces recommendations within its annual reports to improve patient safety .