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Comment & Response
September 27, 2016

Aspirin and Acute Respiratory Distress Syndrome—Reply

Author Affiliations
  • 1Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota
  • 2Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
  • 3Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;316(12):1318. doi:10.1001/jama.2016.12327

In Reply Dr Kuschner is concerned that the dose of aspirin selected for our lung injury prevention trial may have been subtherapeutic and poorly informed based on the supporting literature cited.1,2 A specific highlighted concern is the notable difference in study populations when comparing those previously studied with those who were enrolled in this trial (eg, healthy volunteers vs those with acute illness and risk for ARDS). Such concerns, in addition to the well-documented potential for aspirin resistance, greatly influenced the study design. Indeed, the decision to provide an initial loading dose of aspirin (325 mg) was driven by the desire to mitigate the potential for insufficient dosing of the study medication while also attempting to balance potential risks for adverse events associated with aspirin administration.