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A huge amount of research has focused on the mechanisms of acute lung injury and yet the exact sequence of events and media tors in inflammatory cascade, which result in acute respiratory failure from ARDS, is not known but many possibilities exist.
Part 1 Introduction and overview: introduction and definition; epidemiology; spectrum of disease; diffuse alveolar damage. Part 2 Basic mechanisms: mechanisms of resolution of lung inflammation; complement, endotoxin and acute lung injury; cytokines and lung injury; mechanisms of neutrophil mediated injury; adhesion molecules; proteinases; reactive oxygen species, antioxidant protection and lung injury; epithelial injury and repair; mechanisms of scarring; secondary infections in acute lung injury. Part 3 Physiology: pulmonary physiology of acute lung injury; surfactant system in lung injury; pulmonary vascular control mechanisms; systemic manifestations; tissue oxygenation; critical role of the alveolar epithelial barrier. Part 4 Clinical management: imaging the injured lung; severity scoring; a pressure targeted approach to ventilating; high frequency techniques of oxygenation; extracorporeal membrane oxygenation; intravascular gas exchange; clinical trial issues. Part 5 Thrapeutic interventions: fluid balance and renal function; inhaled nitric oxide therapy; prospects for pharmacotherapy.