Racial differences in allergen sensitivity.

rious consequences. In our study, the presence of BPF was not associated with the in-hospital mortality rate (mortality in patients with BPF, 46%; mortality in patients without BPF, 50%). In our experience, BPF rarely has important effects on gas exchange, and, in fact, a substantial quantity of ventilation has been reported3,4 to occur via the chest tube in patients with BPF. While BPF has limited ventilator liberation in the past, the current guidelines recommend continuing spontaneous breathing trials to liberate patients from mechanical ventilation regardless of chest tube status.5 Finally, our experience has been that with the use of lower transpulmonary pressures in the ventilation of ARDS patients, the risk of BPF from lung biopsy has fallen considerably.6,7 Thus, we continue to believe that surgical lung biopsy can be safely performed in selected ARDS patients.