Alveolar fluid clearance in acute lung injury: what have we learned from animal models and clinical studies?

Byline: Rory E. Morty (1), Oliver Eickelberg (1), Werner Seeger (1) Keywords: Acute respiratory distress syndrome; Edema; Sodium transport; Isolated lung; Epithelial sodium channel; Na,K-ATPase Abstract: Background Acute lung injury and the acute respiratory distress syndrome continue to be significant causes of morbidity and mortality in the intensive care setting. The failure of patients to resolve the alveolar edema associated with these conditions is a major contributing factor to mortality hence there is continued interest to understand the mechanisms of alveolar edema fluid clearance. Discussion The accompanying review by Vadasz eta-al. details our current understanding of the signaling mechanisms and cellular processes that facilitate clearance of edema fluid from the alveolar compartment, and how these signaling processes may be exploited in the development of novel therapeutic strategies. To complement that report this review focuses on how intact organ and animal models and clinical studies have facilitated our understanding of alveolar edema fluid clearance in acute lung injury and acute respiratory distress syndrome. Furthermore, it considers how what we have learned from these animal and organ models and clinical studies has suggested novel therapeutic avenues to pursue. Author Affiliation: (1) Department of Internal Medicine, University of Giessen Lung Center, Justus Liebig University, Klinikstrasse 36, 35392, Giessen, Germany Article History: Registration Date: 11/04/2007 Received Date: 12/08/2006 Accepted Date: 05/03/2007 Online Date: 25/05/2007 Article note: This article refers to the articles available at: http://dx.doi.org/10.1007/s00134-007-0625-z and http://dx.doi.org/10.1007/s00134-007-0661-8