EDITORIALS
The pulmonary protein C system: preventive or therapeutic target in acute lung injury?
1 Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
2 Laboratory of Experimental Intensive Care and Anesthesiology (LEICA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
3 HERMES Critical Care Group, Amsterdam, The Netherlands
4 Department of Intensive Care Medicine, St Vincent’s Hospital, Melbourne, Australia
5 Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Correspondence to:
Dr M J Schultz, Department of Intensive Care Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; m.j.schultz@amc.uva.nl
| The first 150 words of the full text of this article appear below. |
Acute lung injury or its more severe form—acute respiratory distress syndrome (ARDS)—are common and important intensive care syndromes affecting many patients. Acute lung injury is characterised by damage to the alveolar-capillary membrane resulting in alveolar flooding, pulmonary inflammation and alveolar coagulopathy, and changes in surfactant properties with severe impairment of oxygenation and respiratory failure mandating mechanical ventilation. It is rarely present at the time of hospital admission but develops over a period of hours to days in subsets of patients with predisposing conditions such as trauma, shock or sepsis, and accompanying interventions including mechanical ventilation and transfusion.1 Acute lung injury may therefore be viewed as a potentially preventable complication. Indeed, implementation of acute lung injury prevention strategies such as lung-protective mechanical ventilation using normal-sized tidal volumes and restrictive blood transfusion leads to a significant decrease in acute lung injury and mortality of mechanically ventilated patients.2 Pharmacotherapies targeting progression to acute
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