Critical Care

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Commentary

Inhaled activated protein C: a novel therapy for acute lung injury?

Kathleen D Liu1, Mark R Looney2 and Michael A Matthay2*

Author Affiliations

1 Divisions of Nephrology and Critical Care Medicine, Departments of Medicine and Anesthesia, University of California, San Francisco, San Francisco, CA 94143-0624, USA

2 Cardiovascular Research Institute and the Division of Pulmonary and Critical Care Medicine, Departments of Medicine and Anesthesia, University of California, San Francisco, San Francisco, CA 94143-0624, USA

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Critical Care 2009, 13:150 doi:10.1186/cc7869

Published: 21 May 2009

Abstract

Acute lung injury (ALI) is characterized by the presence of dysregulated coagulation and inflammation. Therefore, Waerhaug and colleagues hypothesized that administration of activated protein C (APC) via the inhaled route would be a novel and effective treatment for ALI. They demonstrated that inhaled APC improved oxygenation and lung aeration in a sheep model of lipopolysaccharide-induced ALI, but did not alter lung water or hemodynamics. Future studies are needed to determine plasma and airspace APC levels when administered by the inhaled route, and to determine if inhaled APC has a similar effect in other models of ALI.