TACO vs TRALI
Weighs a post-transfusion respiratory event toward circulatory overload or acute lung injury.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Onset within 6 hours of the transfusion
- Yes
- New hypoxemia with bilateral pulmonary infiltrates
- Yes
- Raised natriuretic peptide, or a rise from the pre-transfusion value
- Yes
- Positive fluid balance
- Yes
Result: 2 features pointing to circulatory overload and none away from it
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Common to both
- Onset within 6 hours of the transfusion, with new hypoxemia and bilateral pulmonary infiltrates.
- Points to overload
- A raised natriuretic peptide, positive fluid balance, raised central venous or pulmonary artery pressure, cardiogenic signs, or improvement with diuresis.
- Points to lung injury
- No evidence of hydrostatic pulmonary edema, and no other risk factor for acute respiratory distress syndrome or one present but stable.
- Why it matters
- The treatments diverge. Overload is treated by removing volume; lung injury is not, and a diuretic given to a patient who is not overloaded makes them worse.
- Before either
- Stop the transfusion and report the event. That does not wait on the distinction.
- Both at once
- They can coexist. Features on both sides are a reason to treat the picture in front of you, not to pick a label.
What you enter
- Onset within 6 hours of the transfusion (an entry criterion for both)
- New hypoxemia with bilateral pulmonary infiltrates (an entry criterion for both)
- Raised natriuretic peptide, or a rise from the pre-transfusion value (points to circulatory overload)
- Positive fluid balance (points to circulatory overload)
- Raised central venous or pulmonary artery pressure (points to circulatory overload)
- Cardiogenic signs: a third heart sound, widened pulse pressure, or raised jugular venous pressure (points to circulatory overload)
- Improvement with diuresis (points to circulatory overload)
- No evidence of hydrostatic pulmonary edema (points to acute lung injury)
- No other risk factor for acute respiratory distress syndrome, or one present but stable (points to acute lung injury)
How this is calculated
Vlaar APJ, Toy P, Fung M, et al. A consensus redefinition of transfusion-related acute lung injury. Transfusion. 2019;59(7):2465-2476. ISBT/AABB transfusion-associated circulatory overload surveillance case definition, 2018 revision. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.