FIG. 2.

The natural history of ALI/ARDS includes resolution and repair versus persistence and progression. Clinical and epidemiologic studies demonstrate that ALI/ARDS resolves with return of alveolar function to normal or near normal in some patients, whereas in others there is persistence and/or progression of injury. The outcomes of persistence and progression include multiple organ failure, fibrosing alveolitis, pulmonary vascular obliteration with pulmonary hypertension, and death. The genetic, cellular, molecular. and iatrogenic factors that contribute to each of these outcomes remain largely unknown. In addition, rational mechanism-based strategies that favorably influence repair of the alveolar–capillary membrane are undefined. Reprinted with the permission of the publisher.⁽²³⁾ Copyright 2005 American Thoracic Society. All rights reserved.