Recent studies have shown that chronic alcohol abuse is associated with excessive morbidity and mortality in critically sick patients, and is an independent risk factor for non-cardiac diseases to develop acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Chronic alcohol abuse damages pulmonary vascular endothelial cells and alveolar epithelial cells through a variety of mechanisms, which results in increase of the alveolar-capillary permeability and extra vascular lung water level. Clinicians should pay attention to this phenomenon and further studies should be explored to identify the mechanisms involved in the predisposition to ALI/ARDS. Application of angiotensin receptor antagonist, recombinant granulocyte/macrophage colony stimulating factor, glutathione precursors and zinc supplementation may be useful to prevent and treat the patient who is a chronic alcohol abuser and at high risk of suffering from ALI/ARDS.
