ABSTRACT
Sepsis, a systemic condition with several stages and degrees of severity resulting from dysregulated activation of the innate immune and hemostatic systems, is a lethal syndrome and a major cause of acute lung injury (ALI) and its progression to the acute respiratory distress syndrome (ARDS). The concept that sepsis can lead to end-organ injury and dysfunction dates to the Greek origin of the term (“sepsios”) and to investigations of its pathogenesis that predate modern times (1). Although not reported as a cause of lung injury in the 12 patients in the seminal description of ARDS by Petty and coworkers (2), sepsis was later recognized as a major inciting factor (3). In addition, many subsequent reports demonstrated an association between sepsis and ALI, and consensus statements and recent reviews identify it as a leading condition that “triggers” the molecular and cellular cascades that culminate in ALI and ARDS (ALI/ARDS) in humans (4-8). These and related issues were discussed in a previous version of this chapter (9), which will be referred to frequently and which contains additional references that will not be cited here. A very large number of studies and reports relevant to sepsis, ALI, and ARDS have appeared since that time; we profile this literature, but do not attempt to discuss each key area in comprehensive fashion. Many of the topics discussed in the chapter are themselves the subjects of detailed reviews, which are given in the reference list.
