Acute lung injury
Citation, DOI & article data
Acute lung injury (ALI) refers to a rather broad clinical syndrome defined by a constellation of clinical criteria:
acute onset of bilateral pulmonary infiltrates
without evidence of hydrostatic pulmonary edema
pulmonary wedge pressures of usually 18 mmHg or less
It encompasses and also carries some overlap with the term acute respiratory distress syndrome (ARDS) with some publications stating a PaO2/FiO2 of:
≤300 for ALI 1
≤200 for ARDS 1
Some publications state ARDS as a more severe form of ALI.
Histologically, it is represented by diffuse alveolar damage in most cases but can also be uncommonly represented by acute eosinophilic pneumonia (AEP) and acute fibrinous and organizing pneumonia (AFOP) 6. It can be precipitated by numerous agents.
Treatment and prognosis
Treatment is primarily supportive through supplemental oxygen with mechanical ventilation provided if necessary. The prognosis is variable.
- 1. Johnson ER, Matthay MA. Acute lung injury: epidemiology, pathogenesis, and treatment. (2010) Journal of aerosol medicine and pulmonary drug delivery. 23 (4): 243-52. doi:10.1089/jamp.2009.0775 - Pubmed
- 2. Ragaller M, Richter T. Acute lung injury and acute respiratory distress syndrome. (2010) Journal of emergencies, trauma, and shock. 3 (1): 43-51. doi:10.4103/0974-2700.58663 - Pubmed
- 3. Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, Stern EJ, Hudson LD. Incidence and outcomes of acute lung injury. (2005) The New England journal of medicine. 353 (16): 1685-93. doi:10.1056/NEJMoa050333 - Pubmed
- 4. Elicker BM, Jones KT, Naeger DM, Frank JA. Imaging of Acute Lung Injury. (2016) Radiologic clinics of North America. 54 (6): 1119-1132. doi:10.1016/j.rcl.2016.05.006 - Pubmed
- 5. Cereda M, Xin Y, Goffi A, Herrmann J, Kaczka DW, Kavanagh BP, Perchiazzi G, Yoshida T, Rizi RR. Imaging the Injured Lung: Mechanisms of Action and Clinical Use. (2019) Anesthesiology. 131 (3): 716-749. doi:10.1097/ALN.0000000000002583 - Pubmed
- 6. Obadina ET, Torrealba JM, Kanne JP. Acute pulmonary injury: high-resolution CT and histopathological spectrum. (2013) The British journal of radiology. 86 (1027): 20120614. doi:10.1259/bjr.20120614 - Pubmed