Transfusion-related acute lung injury (TRALI)

This code identifies a severe, non-cardiogenic pulmonary edema that develops acutely following a blood product transfusion. It is characterized by hypoxemia, bilateral infiltrates on chest imaging, and no evidence of circulatory overload. TRALI is a leading cause of transfusion-related mortality.

Assign this code when documentation clearly indicates a patient has developed acute lung injury directly attributable to a recent transfusion of blood components (e.g., plasma, platelets, red blood cells). Key diagnostic criteria, such as new onset hypoxemia and bilateral pulmonary infiltrates within 6 hours of transfusion, should be present.

• Ensure documentation explicitly links the acute lung injury to the transfusion event; avoid using for other causes of acute respiratory distress.
• Do not confuse with transfusion-associated circulatory overload (TACO), which involves signs of hypervolemia.
• Sequence this code as a principal diagnosis when it is the reason for admission, or as a secondary diagnosis when it complicates another condition.