title: Lung injury induced by sepsis: lessons learned from large animal models and future directions for treatment.
abstract: Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) remain common complications of sepsis. Unfortunately, development of effective pharmacologic and ventilatory treatment strategies for sepsis-induced ALI/ARDS has not made significant progress over the past several decades. One of the major reasons for this conundrum involves the animal models used as platforms for testing new treatment strategies. High-fidelity, clinically translational, large animal models are essential for developing treatments that will ultimately be successful in human clinical trials. Additionally, treatment strategies purely based on pharmacologic intervention are largely destined for failure as the redundancies in the systemic inflammatory response largely negate the effectiveness of a single-action drug. Conversely, a treatment strategy based on the appropriate use of mechanical ventilation affects lung physiology on a breath-to-breath basis and has the potential to treat, and even prevent, the ALI/ARDS associated with sepsis.
authors: Department of Surgery, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA.
authors: Benjamin
authors: B
authors: Sadowitz
authors: Shreyas
authors: S
authors: Roy
authors: Louis A
authors: LA
authors: Gatto
authors: Nader
authors: N
authors: Habashi
authors: Gary
authors: G
authors: Nieman
mesh_terms: D055371:Acute Lung Injury / Q000209:etiology / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000818:Animals; D004195:Disease Models, Animal; D006651:Histocytochemistry; D006801:Humans; D007442:Intubation, Intratracheal; D008070:Lipopolysaccharides / Q000008:administration & dosage / Q000009:adverse effects; D008168:Lung / Q000187:drug effects / Q000382:microbiology* / Q000473:pathology; D011486:Protein C / Q000008:administration & dosage / Q000627:therapeutic use; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018805:Sepsis / Q000150:complications / Q000382:microbiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012756:Sheep; D013045:Species Specificity; D013552:Swine
chemical_list: D008070:Lipopolysaccharides; D011486:Protein C