Introduction
Acute Lung Injury, ARDS
ACUTE RESPIRATORY DISTRESS SYNDROME, DISEASE, PATHOPHYSIOLOGY, CRITICAL ILLNESS, ARDS
Acute respiratory distress syndrome (ARDS) is a lethal disease without laboratory-guided diagnostic or prognostic biomarkers [Identification of ARDS sub-phenotypes using biomarkers has been proposed, but these efforts have primarily relied on non-specific biomarkers, such as inflammatory cytokines (e.g., IL-6, IL-1B, TNFa), which may represent general critical illness common to ARDS [Matrix metalloproteinases (MMPs) are extracellular proteases capable of degrading every part of the extracellular matrix and the proteins of the alveolar epithelial-endothelial unit under pro-inflammatory conditions, a process central to ARDS pathophysiology [Given the evidence supporting MMPs as contributors to ARDS pathophysiology, this study sought to explore the relationship of MMP-3 changes early in ARDS with patient outcomes in the context of a robust randomized controlled trial of ARDS patients, Albuterol to Treat Acute Lung Injury (ALTA). The study hypothesized that elevated MMP-3 from both static and dynamic measures would be associated with increased mortality.