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 acute lung injury (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 (NSAIDs)

   - 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