Future research directions in acute lung injury: summary of a National Heart, Lung, and Blood Institute working group.
Acute lung injury (ALI) and its more severe form, the acute respiratory distress syndrome (ARDS), are syndromes of acute respiratory failure that result from acute pulmonary edema and inflammation. The development of ALI/ARDS is associated with several clinical disorders including direct pulmonary injury from pneumonia and aspiration as well as indirect pulmonary injury from trauma, sepsis, and other disorders such as acute pancreatitis and drug overdose. Although mortality from ALI/ARDS has decreased in the last decade, it remains high. Despite two major advances in treatment, low VT ventilation for ALI/ARDS and activated protein C for severe sepsis (the leading cause of ALI/ARDS), additional research is needed to develop specific treatments and improve understanding of the pathogenesis of these syndromes. The NHLBI convened a working group to develop specific recommendations for future ALI/ARDS research. Improved understanding of disease heterogeneity through use of evolving biologic, genomic, and genetic approaches should provide major new insights into pathogenesis of ALI. Cellular and molecular methods combined with animal and clinical studies should lead to further progress in the detection and treatment of this complex disease.
Matthay
Michael A
MA
Division of Lung Diseases, National Heart, Lung, and Blood Institute/NIH, Bethesda, MD, USA.
Zimmerman
Guy A
GA
Esmon
Charles
C
Bhattacharya
Jahar
J
Coller
Barry
B
Doerschuk
Claire M
CM
Floros
Joanna
J
Gimbrone
Michael A
MA
Hoffman
Eric
E
Hubmayr
Rolf D
RD
Leppert
Mark
M
Matalon
Sadis
S
Munford
Robert
R
Parsons
Polly
P
Slutsky
Arthur S
AS
Tracey
Kevin J
KJ
Ward
Peter
P
Gail
Dorothy B
DB
Harabin
Andrea L
AL
D000047:Academies and Institutes / Q000592:standards / Q000639:trends; D000818:Animals; D005544:Forecasting; D006801:Humans; D015994:Incidence; D012106:Research / Q000592:standards* / Q000639:trends*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014481:United States / Q000453:epidemiology