The lung in multiorgan failure

Abstract

The lung is almost invariably involved in the syndrome of multiorgan failure. However the mortality of acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) is largely determined by concurrent non-lung organ failures. Increasingly, the role of mechanical ventilation has been recognized not only as a cause of ALI/ARDS, but also potentially contributing to the development of mutilorgan failure by the release of inflammatory and programmed cell death biological signals acting on organs distant from the lungs. This review summarizes the current epidemiology of ALI/ARDS, particularly with regards to its contribution to multiorgan failure. The potential mechanisms by which lung injury including that caused by mechanical ventilation are analyzed and current treatment strategies detailed.