02450nas a2200181   4500008004100000020001400041024001700055245007400072210006900146260024600215300001400461490000700475520167800482100002202160700002102182700001602203856004902219       2012                        eng d  a0041-1132  awdn, 041736000aTransfusion-associated circulatory overload after plasma transfusion.0 aTransfusionassociated circulatory overload after plasma transfus  aCopyright (C) 2012 Blackwell Publishing Ltd.b(1)From the Department of Pathology, Allegheny General Hospital; the Department of Pathology, University of Pittsburgh; and The Institute for Transfusion Medicine, Pittsburgh, Pennsylvania.c2012  a160 - 1650 v523 aBACKGROUND: In 2010, transfusion-associated circulatory overload (TACO) was the second most common cause of transfusion-related mortality reported to the Food and Drug Administration. We sought to determine the rate of TACO caused by plasma transfusion., STUDY DESIGN AND METHODS: This study was conducted in two parts: 1) A retrospective analysis to determine the prevalence of TACO reactions caused by plasma at a tertiary care hospital from 2003 to 2010 was performed by analyzing the blood bank's electronic transfusion reaction records and 2) active surveillance of plasma recipients to determine if unreported TACO reactions had occurred over a 1-month period at the same hospital., RESULTS: Eighty-seven reactions to plasma had been reported to the blood bank from 2003 through 2010. Of these reactions 23% (20/87) were TACO. The historical prevalence rate of TACO was 1 in 1566 (95% confidence interval [CI], 1:2564-1:1014). During the prospective 1-month surveillance period, 84 patients received a total of 272 units of plasma, and four TACO reactions in separate patients (4.8%) were identified, none of which were reported to the blood bank. The prevalence rate of TACO in the prospective study was 1 in 68 (95% CI, 1:250-1:27). In total, most patients (14/24) were in the intensive care unit when they experienced TACO and on average they had received 4.0 +/- 2.3 units of plasma at an average rate of 647 +/- 315 mL/hr before the TACO reaction., CONCLUSIONS: Passive reporting of TACO grossly underestimates its actual prevalence. Educational efforts are needed to enhance physician recognition of TACO reactions., Copyright (C) 2012 Blackwell Publishing Ltd.1 aNarick, Christina1 aTriulzi, Darrell1 aYazer, Mark  uhttps://www.notifylibrary.org/reference/4342