Role of the coagulation and fibrinolysis in acute lung injury

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common, life-threatening causes of acute respiratory failure that arise from a variety of local and systemic insults. The pathogenesis of ALI/ARDS is complicated and not yet completely interpreted today. The role of altered coagulation and fibrinolysis in the pathogenesis of ALI/ARDS has been investigated. This review will summarize the current understanding of coagulation and fibrinolysis in human ALI/ARDS with emphasis on pathways that could be potential therapeutic targets. These pathways include the tissue factor pathway, the protein C pathway and modulation of fibrinolysis via plasminogen activator inhibitor-1.