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
Citation
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.