Characteristics of pulmonary transfusion reactions
| Characteristic . | TRALI . | Possible TRALI . | TACO . |
|---|---|---|---|
| Bilateral infiltrates on chest radiograph consistent with acute pulmonary edema | Yes | Yes | Yes |
| Evidence of hypoxemia* | Yes | Yes | Yes |
| Evidence of circulatory overload† | No | Yes/no | Yes |
| Presence of major ARDS risk factor(s)‡ | No | Yes | No |
| Characteristic . | TRALI . | Possible TRALI . | TACO . |
|---|---|---|---|
| Bilateral infiltrates on chest radiograph consistent with acute pulmonary edema | Yes | Yes | Yes |
| Evidence of hypoxemia* | Yes | Yes | Yes |
| Evidence of circulatory overload† | No | Yes/no | Yes |
| Presence of major ARDS risk factor(s)‡ | No | Yes | No |
Hypoxemia defined as PaO2/FiO2 < 300, SpO2 < 90% on room air, or other evidence of hypoxia.
A systematic evaluation of echocardiography (ejection fraction, diastolic function, and ventricular filling pressures), chest radiography (cardiothoracic ratio and vascular pedicle width), laboratory findings (B-type natriuretic peptide and N-terminal pro B-type natriuretic peptide), hemodynamic parameters (systolic blood pressure and central venous pressure), and clinical course (rapid resolution of pulmonary edema after preload reduction favoring a hydrostatic rather than permeability etiology).
Major ARDS risk factors included pneumonia, sepsis, aspiration, multiple fractures, and pancreatitis.