With modern therapy many patients are surviving an initial episode of acute lung injury (ALI). A patient surviving ALI may have a recurrent episode, which oftens has a high mortality rate. Therefore it is important to identify and correct any possible contributory factors.


Factors that have been implicated in recurrent ALI:

(1) recurrent aspiration (due to gastroesophageal reflux, tracheoesophageal fistula, seizure disorder, etc)

(2) opiate or psychotropic drug use


It is important to take a complete and accurate drug history.


Some patients have no identifiable risk factor for the ALI. It is difficult to prevent a second episode if no cause for the first episode can be found.


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