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Incidence and Outcomes of Acute Lung Injury

2006; Massachusetts Medical Society; Volume: 354; Issue: 4 Linguagem: Inglês

10.1056/nejmc053159

1533-4406

Gökhan M. Mutlu, G. R. Scott Budinger,

Chronic Obstructive Pulmonary Disease (COPD) Research

to the editor: Rubenfeld and colleagues (Oct. 20 issue)1 discuss the incidence and outcomes of acute lung injury in a large, population-based cohort study. The authors provide data on the known risk factors of acute lung injury and convincingly suggest that their population cohort was representative of the U.S. population as a whole. We are surprised, however, that they did not include data that address characteristics that might protect patients against the development of acute lung injury. As previously reported by Moss and colleagues, the incidence of and mortality from acute respiratory distress syndrome are reduced in patients with diabetes mellitus.2 Experimental data published more recently3 support these data on humans. Although the mechanisms by which diabetes provides “protection” against acute lung injury are not well understood, leptin resistance may play an important role. In future studies, inclusion of data about patient characteristics that either improve or worsen the outcomes of acute lung injury might facilitate the development of novel strategies to improve the care of patients with this deadly disease. Gokhan M. Mutlu, M.D. G.R. Scott Budinger, M.D.