A patient in ICU was given blood transfusion. 3 hours later SpO2 is reduced to 75% with respiratory difficulty. CVP is 15cm water and PCWP is 25mm Hg. CXR is shown below. What should be the diagnosis ?
Tension pneumothorax
Transfusion related acute lung injury
Transfusion associated circulatory overload
Mismatched blood transfusion
The presence of respiratory distress after blood transfusion along with elevated CVP and PCWP points towards diagnosis of Transfusion associated circulatory overload TACO TRALI Ejection Fraction < 40% > 40% PCWP > 18 mm Hg <= 18 mm Hg CXR CTR > 0.55 CTR < 0.55 Fluid Balance Positive Neutral BNP > 1200 pg/mL < 250 pg/mL BP | | Temperature Unchanged Febrile WBC Unchanged Transient |
Blood Bank & Transfusion Therapy