Criteria for TRALI – both of the following:
(1) chest X-ray ordered within 8 hours of the transfusion because the physician is concerned about respiratory compromise
(2) hypoxemic respiratory insufficiency as indicated by one or more of the following:
(2a) PaO2 < 60 mm Hg
(2b) PaO2 to FIO2 ratio < 300 mm Hg
(2c) oxygen saturation (SpO2) < 90%
Surveillance algorithm for TRALI – both of the following:
(1) chest X-ray obtained within 8 hours of blood product transfusion
(2) PaO2 to FIO2 ratio <= 288 mm Hg (surrogates PaO2 <= 117 mm Hg or SpO2 <= 97%
Criteria for TACO – all of the following:
(1) hypoxemic respiratory insufficiency as indicated by one or more of the following:
(1a) PaO2 < 60 mm Hg
(1b) PaO2 to FIO2 ratio < 300 mm Hg
(1c) oxygen saturation (SpO2) < 90%
(2) one or both of the following:
(2a) dyspnea (respiratory rate > 20 breaths per minute OR PaCO2 < 32 mm Hg)
(2b) hemodynamic instability (>= 20% increase in systolic blood pressure or heart rate compared to pre-transfusion baseline)
(3) evidence of circulatory overload with one or more of the following:
(3a) central venous pressure > 12 mm Hg
(3b) pulmonary capillary wedge pressure > 18 mm Hg
(3c) chest X-ray obtained within 8 hours of blood product transfusion
(3d) diuretic administration
Surveillance algorithm for TACO – both of the following:
(1) PaO2 to FIO2 ratio <= 292 mm Hg (surrogates PaO2 <= 130 mm Hg, SpO2 <= 96%, respiratory rate >= 17 breaths per minute)
(2) chest X-ray performed within 8 hours of blood product transfusion
Both of the surveillance algorithms are close to each other. The full criteria should be able to be implemented in the HER.
