Camporota and colleagues’ study is interesting and confirms previous observations that no additional anticoagulation Kyprolis is necessary during simultaneous DrotAA infusion and CRRT. The only information that should be interpreted with caution is the authors’ finding that no difference in red blood cell requirements was found, either between DrotAA filters and post-DrotAA filters or between medical patients and surgical patients. It should be remembered that, among the 4,459 patients included in the International Integrated Database for the Evaluation of Severe Sepsis and Drotrecogin alfa (activated) Therapy study, the bleeding incidence in surgical patients was about 10 times higher in the DrotAA group than in the placebo group (4.9% vs. 0.5%), and the incidence in medical patients was about 2.

5 times higher than that in surgical patients (2.6% vs. 1%) [29,30].AbbreviationsAKI: acute kidney injury; AKIN: Acute Kidney Injury Network; CRRT: continuous renal replacement therapy; DrotAA: drotrecogin A activated; HIT: heparin-induced thrombocytopenia; ICU: intensive care unit; OR: odds ratio; RIFLE: Risk, Injury, Failure, Loss of kidney function, and End-stage; RRT: renal replacement therapy.Competing interestsThe authors declare that they have no competing interests.
ALI and acute respiratory distress syndrome (ARDS) are major causes of morbidity and mortality, and account for a large proportion of intensive care unit (ICU) bed use. Many pharmacological interventions for these entities have been evaluated, but none has clearly been shown to decrease mortality [1].

To help develop novel treatment strategies for patients with ALI/ARDS, the Irish Critical Care Trials Group conducted a study in a cohort of patients with ALI/ARDS in the Irish adult ICU population [2]. The investigators Drug_discovery described the epidemiology and management of ALI/ARDS in order to identify factors associated with outcome, and to identify whether standardized care is being delivered across participating centres in a research network. There were 1,029 admissions during a 10-week study period in 14 participating centres. A total of 196 (19%) patients had ALI/ARDS; of these 141 (72%) had ALI/ARDS on admission. The most common predisposing risk factors were pneumonia (50%) and extrapulmonary sepsis (26%). Although protective lung ventilation (mean tidal volume 7.0 �� 1.7 ml/kg) was used commonly throughout participating centres, the overall ICU mortality for ALI/ARDS was 32.3%. Lower arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratios and higher Sequential Organ Failure Assessment scores at admission were associated with increased mortality. These data are helpful in planning future multicentre clinical trials in patients with ALI/ARDS.