LIPS-A: Lung Injury Prevention Study With Aspirin

Inclusion Criteria:

- Adult patients (age > 18) admitted to the hospital through the emergency department
(ED)

- At high risk of developing ALI (Lung Injury Prediction Score-LIPS greater than or
equal to 4)

Exclusion Criteria:

- Anti-platelet therapy on admission or within 7 days prior to admission

- Presented to outside hospital ED > 12 hrs before arrival at site's facility

- Inability to obtain consent within 12 hours of hospital presentation

- Admitted for elective surgery

- Acute lung injury prior to randomization

- Receiving mechanical ventilation through a tracheostomy tube prior to current
hospital admission (patient who is ventilator dependent)

- Presence of bilateral pulmonary infiltrates on admission if he or she has a history
of bilateral pulmonary infiltrates (as evidenced by previous x-rays) that can
reasonably explain the current degree of pulmonary infiltrates present.

- Presentation due to pure heart failure and no other known risk factors for ALI.

- Allergy to aspirin or non steroidal anti inflammatory drugs (NSAID's)

- Bleeding disorder

- Suspected active bleeding or judged to be at high risk for bleeding

- Active peptic ulcer disease (within past 6 months)

- Severe chronic liver disease

- Inability to administer the study drug

- Expected hospital stay < 48 hours

- Admitted for comfort or hospice care

- Patient, surrogate or physician not committed to full support (Exception: a patient
will not be excluded if he/she would receive all supportive care except for attempts
at resuscitation from cardiac arrest)

- Not anticipated to survive > 48 hours

- Previously enrolled in this trial

- Enrolled in a concomitant intervention trial

- Pregnant or breastfeeding