Citations 2
Beyond Mortality: Future Clinical Research in Acute Lung Injury
Spragg, Roger G., Bernard, Gordon R. , Checkley, William , Gajić, Ognjen, Hall, Jesse B., Israel, Elliott, Jain, Manu , Needham, Dale M. , Randolph, Adrienne G. , Rubenfeld, Gordon D., Schoenfeld, David , Ware, Lorraine B. , Young, Duncan , Harabin, Andrea L., Curtis, J. Randall , Guyatt, Gordon , Thompson, Bruce , Randolph, Adrienne G
American Journal of Respiratory and Critical Care Medicine | March 11, 2010 | Volume: 181 | Issue: 10 | Pages: 1121-1127
Abstract Mortality in National Heart, Lung and Blood Institute–sponsored clinical trials of treatments for acute lung injury (ALI) has decreased dramatically during the past two decades. As a consequence, design of such trials based on a mortality outcome requires ever-increasing numbers of patients. Recognizing that advances in clinical trial design might be applicable to these trials and might allow trials with fewer patients, the National Heart, Lung and Blood Institute convened a workshop of extramural experts from several disciplines. The workshop assessed the current state of clinical research addressing ALI, identified research needs, and recommended: (1) continued performance of trials evaluating treatments of patients with ALI; (2) development of strategies to perform ALI prevention trials; (3) observational studies of patients without ALI undergoing prolonged mechanical ventilation; and (4) development of a standardized format for reporting methods, endpoints, and results of ALI trials.
Future Research Directions in Acute Lung Injury: Summary of a National Heart, Lung, and Blood Institute Working Group
Matthay, Michael A. , Esmon, Charles, Bhattacharya, Jahar , Floros, Joanna, Gimbrone, Michael A., Hubmayr, Rolf D., Matalon, Sadis , Munford, Robert S., Parsons, Polly E., Slutsky, Arthur S. , Tracey, Kevin J. , Ward, Peter A. , Gail, Dorothy B., Harabin, Andrea L., Zimmerman, Guy A. , Esmon, Charles T., Coller, Barry S. , Doerschuk, Claire M. , Hoffman, Eric P. , Leppert, Mark
American Journal of Respiratory and Critical Care Medicine | March 27, 2003 | Volume: 167 | Issue: 7 | Pages: 1027-1035
Abstract 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.