Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Anticoagulant therapy in acute lung injury: a useful tool without proper operating instruction? | Available online http content 12 5 179 Commentary Anticoagulant therapy in acute lung injury a useful tool without proper operating instruction Sebastian Rehberg Perenlei Enkhbaatar and Daniel L Traber Department of Anesthesiology The University of Texas Medical Branch 301 University Blvd 77555 Galveston TX USA Corresponding author Sebastian Rehberg serehber@ Published 22 September 2008 This article is online at http content 12 5 179 2008 BioMed Central Ltd Critical Care 2008 12 179 doi cc7002 See related research by Waerhaug et al. http content 12 4 R104 Abstract Activation of the coagulation cascade resulting in alveolar fibrin deposition is recognized as a hallmark of acute lung injury ALI . Anticoagulant treatment with recombinant human activated protein C rhAPC appears promising because - like in sepsis - there is a deficiency of protein C in ALI which is correlated with poor outcome in both syndromes. Recently in Critical Care Waerhaug and colleagues confirmed the beneficial effects of rhAPC on pulmonary function in ovine endotoxin-induced ALI. Notably the authors reported no differences in hemorrhage in histologic analyses between rhAPC-treated and untreated animals. However a recently reported randomized placebo-controlled multicenter trial in ALI patients without severe sepsis failed to identify any differences in the number of ventilator-free days or 60 day-mortality between the rhAPC and placebo group. In addition to or perhaps because of the complex pathogenesis the discrepancy between clinical and experimental results in ALI is another common feature with sepsis. The future challenge will be to transfer our theoretical knowledge adequately into daily clinical practice. Anticoagulant therapy might be a useful tool in the treatment of ALI however the proper operating instruction remains to be defined. Activation of the coagulation cascade resulting in alveolar fibrin deposition is recognized as a .
