Acute Lung Injury (ALI) is a common condition that is characterized by severe acute hypoxia that is not due to left atrial hypertension. ALI was first described by Ashbaugh in the Lancet in 1967. This landmark paper described a group of 12 patients with “Respiratory Distress Syndrome” who had refractory hypoxemia, decreased lung compliance, diffuse infiltrates on chest radiography and required positive end-expiratory pressure (PEEP) for ventilation. ALI encompasses a continuum of clinical and radiographic changes that affect the lungs with acute respiratory distress syndrome (ARDS). ALI is diagnosed clinically based on the presence of non-cardiogenic pulmonary odema and respiratory failure in a critically ill patient. Its incidence is common; it is likely to exist outside the intensive care setting and therefore is a condition relevant to all clinicians. The respiratory failure associated with the acute lung injury or the acute respiratory distress syndrome (ARDS), is one of the most important contributors to postoperative mortality. Causes of ALI include sepsis, burns, radiation, inhalation of noxious fumes and fat embolism. Symptoms include severe shortness of breath, low blood pressure, confusion and extreme tiredness. ALI is a multi-factorial process which occurs due to environmental triggers occurring in genetically predisposed individuals, as ALI-inducing events are common, yet only a fraction of those exposed develop the syndrome. Environmental triggers for developing ALI can be divided into those causing direct and those causing indirect lung injury, with sepsis, either intrapulmonary or extrapulmonary being the commonest cause.
Moreover, growing geriatric population and technological advancements would drive the global acute lung injury market. However, the low adoption rate of digital radiography and portable spirometers are projected to hold back the growth of acute lung injury market during the forecast period.
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The key mass drivers supporting the market growth of acute lung injury are growing awareness related to daily health diagnostics, patients are expected to prefer digital diagnostic over laboratory or hospital visit, and this technology platform is estimated to surge the approachability for patients as well as medical practitioners. Acute lung injury market often depresses entry barriers, causing established boundaries between sectors to tumble. Currently, there is no specific treatment for ARDS. Therefore, treatment strategies for ALI and ARDS must address the following three considerations:
- Mechanical ventilation to secure oxygenation and CO2 elimination
- Adjunctive procedures for the treatment of specific pulmonary pathologies
- Fluid Management
Despite the advancements in both the surgical techniques and the perioperative management, the incidence of postoperative ALI is still quite remarkable. Postoperative ALI occurs in about 0, 2-5% of the surgical patients submitted to major surgery. The occurrence of postoperative ALI is conditioned by the type of surgery ranging from 2-4% after thoracotomy for lung resection to <0, 5% after cardiac surgery. Despite advances in identification and management, morbidity and mortality are still high. Care should focus on supportive treatment and manage the underlying cause, while specifically aim for low volume ventilation and conservative fluid balance. Ongoing research is still needed to hone the diagnostic criteria, define genetic risk factors and develop new treatment strategies to improve outcome. The new challenge for clinicians is how to address the long-term outcomes of survivors and their relatives which will be an increasingly important problem in the future.
Based on geography, the global acute lung injury market is segmented into five key regions, North America, Europe, Asia-Pacific, Latin America, and the Middle East and Africa. North America is the leading regional market for acute lung injury and is trailed by Europe due to the existence of a large number of population suffering from diseases, and high patient awareness related to disease diagnosis in these regions. Some countries from Asia–Pacific and Latin America are expected to enter the market late because of lack of digital infrastructure, and accessibility to advanced technology. However, rising healthcare expenditure, developing healthcare infrastructure and increasing awareness related to the disease diagnosis. However, poor healthcare facilities in underdeveloped and emerging countries which lack appropriate healthcare infrastructure and trained staff is anticipated to affect the adoption in these countries.
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Currently, various molecules of different companies are under development in Phase II, Phase I and Preclinical. Similarly, the Universities portfolio in preclinical and discovery stages comprises of seven and three molecules, respectively. Some of the major players in the global acute lung injury market include
- Altor BioScience Corporation
- Forschung und Entwicklung GmbH
- Commence Bio
- FirstString Research
- GlaxoSmithKline Plc
- Histocell S.L.
- Navigen Pharmaceuticals
- Noxxon Pharma AG
- S-Evans Biosciences
- Silence Therapeutics Plc
- Stemedica Cell Technologies
- Windtree Therapeutics