Alcohol is one of the most commonly abused substances in the world and chronic alcohol abuse is present in as many as 10 percent of all hospital admissions. Alcohol is involved in more than 50 percent of traumatic injuries, according to some reports, and is a relatively frequent condition for patients in the ICU.
A comprehensive prospective cohort study from our group documented chronic alcohol abuse to occur in approximately 40 percent of admissions to a medical ICU and to be associated with adverse clinical outcomes. Investigators in our group were the first to identify chronic alcohol abuse as an important factor in ALI/ARDS. People who chronically abuse alcohol are more than two times more likely to develop ALI/ARDS compared to non-alcoholics, and also twice as likely to die if they develop ARDS. Our group has also identified that chronic alcohol abuse predisposes to the development of multiple organ dysfunction syndrome (MODS) in patients with sepsis.
Within the Emory Alcohol and Lung Biology Center, our colleagues have documented tremendous alterations in local pulmonary antioxidant status that lead to altered permeability of the alveolar-capillary barrier. These abnormalities more readily permit the accumulation of pulmonary edema, as shown in humans with ALI/ARDS who have greater quantities of pulmonary edema fluid compared to non-alcoholics, and thus contribute to the worse outcomes we and other have observed with ALI/ARDS.