Table 1 Distinguishing TRALI from TACO and ARDS
From: Critical care considerations in the management of the trauma patient following initial resuscitation
Finding | TRALI | ARDS | TACO |
|---|---|---|---|
Vital signs | May be febrile; hypotension more common than hypertension | Variable | Typically normothermic; hypertension |
Clinical examination | Crackles | Crackles | Crackles, S3, jugular venous distension |
ECHO findings | Normal to slightly decreased ventricular function; no evidence of left atrial hypertension | Normal to slightly decreased ventricular function; no evidence of left atrial hypertension | Decreased ejection fraction |
Pulmonary artery occlusion pressure | < 18 mmHg | <18 mmHg | > 18mmHg |
Fluid balance | Hyper-, hypo-, or normovolemic | Hyper-, hypo-, or normovolemic | Hypervolemic |
Brain natriuretic peptide (BNP) level | < 200 pg/mL | < 200 pg/mL | > 1200 pg/mL |
White blood cell count | Typically decreased; may be transient | Variable | Usually unchanged from baseline |
Leukocyte antibodies | Donor leukocyte antibodies present; crossmatch incompatibility between donor and recipient | Donor leukocyte antibodies may or may not be present | Donor leukocyte antibodies may or may not be present |
PaO2/FiO2 gradient | ≤ 300 | ≤ 200 | Variable |