What does the nurse identify as INDIRECT causes of acute respiratory distress syndrome (ARDS)? (SELECT ALL THAT APPLY)

A. Blood transfusion can cause transfusion-related acute lung injury (TRALI), an indirect cause of ARDS. B. Sepsis is a common indirect cause of ARDS due to systemic inflammation. C. Aspiration is a direct lung injury causing ARDS. D. Drowning causes direct lung injury. E. Gunshot wound to the leg causes systemic trauma, an indirect cause through inflammatory response.