Acute lung injury (ALI) is commonly encountered in the ICU and is associated with significant mortality. The mainstay of therapy continues to be aggressive supportive care, including low tidal volume ventilation and fluid conservative strategies. Recent developments in the field of ALI include a proposal to modify the diagnostic criteria for ALI in the Berlin Definition and recent randomized controlled trials of the use of neuromuscular blockade, beta-agonists, and feeding strategies. The goal of this article is to review, summarize, and comment on these emerging data and offer practical recommendations for the evidence-based management of ALI.
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