Q: All of the follow are risk factors for Transfusion Related Acute Lung Injury (TRALI) except?

A) Liver transplantation 
B) Alcohol abuse  
C) High peak airway pressure on  mechanical ventilator
D) High interleukin (IL)-8 levels 
E) Negative fluid balance


Answer:  E

Various risk factors have been identified via various studies for TRALI and it includes positive fluid balance. Other factors include liver transplantation, alcohol abuse, septic shock, high peak airway,  smoking, high interleukin (IL)-8 levels, emergency cardiac surgery, hematologic malignancy, massive transfusion and others.


References: 

1. Gajic O, Rana R, Winters JL, et al. Transfusion-related acute lung injury in the critically ill: prospective nested case-control study. Am J Respir Crit Care Med 2007; 176:886. 

2.  Toy P, Gajic O, Bacchetti P, et al. Transfusion-related acute lung injury: incidence and risk factors. Blood 2012; 119:1757.