© 2014 American Society for Parenteral and Enteral Nutrition

jpen.sagepub.com hosted at online.sagepub.com Invited Commentary Acute respiratory disease syndrome (ARDS) is a common complication of critical illness. It can be triggered by a respira-tory infection, such as pneumonia, but is more often a result of sepsis or significant trauma. ARDS is associated with signifi-cant morbidity, prolonged intensive care unit (ICU) and hospi-tal stay, and increased mortality. Inflammation appears to play a central role in ARDS, with inflammatory mediators including histamine, eicosanoids, and cytokines all identified to be involved. A key mediator involved in the pathophysiological responses seen seems to be leukotriene (LT) B 4,1,2 derived mainly from infiltrating neutrophils. Masclans et al3 reported elevated arterial and venous plasma concentrations of the eico-sanoids thromboxane (TX)