Iscimen et al identified risk factors for acute lung injury developing in a patient with septic shock. These factors can help to identify a patient who may benefit from more aggressive management. The authors are from the Mayo Clinic, Uludag University Bursa, Turkey) and Akdeniz University (Antalya, Turkey).

Patient selection: adult > 18 years of age with septic shock admitted to the ICU


Risk factors for acute lung injury by multivariate analysis:

(1) delayed resuscitation from the shock

(2) delayed antibiotic therapy for the sepsis

(3) red blood cell transfusion (suggesting hemorrhage)

(4) recent chemotherapy (indicating the presence of cancer)

(5) tachypnea (odds ratio 2 per standard deviation above normal for the respiratory rate)


Other factors contributing to ALI:

(1) history of chronic alcohol abuse


Other factors reducing the risk of ALI:

(1) diabetes mellitus



• The p value for the primary factors were all < 0.04.

• The p value for chronic alcohol abuse was 0.1 and for diabetes was 0.08.

• Is the elevated respiratory rate a cause or manifestation of lung injury?

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