Introduction Platelet activation has a role in the pathogenesis of ALI. Observational data suggests aspirin treatment may prevent the development of ALI in critically ill patients. However, it is unknown if aspirin usage alters outcomes in patients with established ALI.

Methods All patients with ALI were identified prospectively in a single large regional medical and surgical ICU between December 2010 and July 2012. Demographic, clinical, and laboratory variables were recorded. Aspirin usage, both pre-hospital and during Intensive Care Unit (ICU) stay, was included. The primary outcome was ICU mortality. We used univariate and multivariate analyses to assess the impact of these variables on ICU mortality.

Results Two hundred and two patients with ALI were included. 56 (28%) of these received aspirin either pre-hospital, in ICU, or both. Using multivariate logistic regression analysis, aspirin was found to be protective for ICU mortality. Additional factors that predicted ICU mortality for patients with ALI were vasopressor use and APACHE II score (Table).

Conclusion Aspirin usage is associated with reduced mortality in patients with ALI. Whilst trials are ongoing to assess if aspirin can prevent ALI, these new data support the need for a clinical trial to investigate if aspirin improves outcomes in patients with established ALI.