<prompt> 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 pneumothoraxTransfusion related acute lung injuryTransfusion associated circulatory overloadMismatched blood transfusion  <response>: 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 pgmL 250 pgmL BP Temperature Unchanged Febrile WBC Unchanged Transient 