Mechanisms of repair and remodeling following acute lung injury

At present, we largely lack the ability to correlate the clinical course of patients with acute respiratory distress syndrome (ARDS) with potential fa ctors involved in the biochemical and cellular basis of lung repair. This r equires very large patient databases with measurement of many biochemical p arameters. Important mechanistic determinants during the repair phase can b e sought by correlation with late outcomes, but a large-scale cooperative e ffort among multiple centers with sharing of follow-up data and patient spe cimens is essential. We also lack detailed human histologic material from m any phases of ARDS, particularly the long-term morphologic impact on surviv ors. Establishment of a national registry that follows ARDS survivors and t hat would seek their cooperation in advance in obtaining autopsy specimens when they die would be very valuable. Correlating the pathology with their pulmonary function during recovery would give important insights into reaso ns for the different patterns of abnormal pulmonary functions.