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With mortality upwards of 30%, a high-fidelity pre-clinical model of ARDS, on which to test novel therapeutics, is urgently needed. We used the Yorkshire breed of swine to induce a reproducible model of ARDS in human-sized swine to allow the study of new therapeutics, from both mechanistic and clinical standpoints. For this, animals were anesthetized, intubated and mechanically ventilated, and pH-standardized gastric contents were delivered bronchoscopically, followed by intravenous infusion of Escherichia coli-derived lipopolysaccharide. Once the ratio of arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FIO2) had decreased to &amp;lt;150, the animals received standard ARDS treatment for up to 48\u2005h. All swine developed moderate to severe ARDS. Chest radiographs taken at regular intervals showed significantly worse lung edema after induction of ARDS. Quantitative scoring of lung injury demonstrated time-dependent increases in interstitial and alveolar edema, neutrophil infiltration, and mild to moderate alveolar membrane thickening. This pre-clinical model of ARDS in human-sized swine recapitulates the clinical, radiographic and histopathologic manifestations of ARDS, providing a tool to study therapies for this highly morbid lung disease.<\/jats:p>","DOI":"10.1242\/dmm.049603","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T13:08:05Z","timestamp":1660741685000},"source":"Crossref","is-referenced-by-count":7,"title":["A clinically relevant model of acute respiratory distress syndrome in human-size swine"],"prefix":"10.1242","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2179-6787","authenticated-orcid":false,"given":"Sarah R.","family":"Kaslow","sequence":"first","affiliation":[{"name":"Columbia University Medical Center, New York, NY 10032, USA 1 Department of Surgery ,"},{"name":"Columbia University, New York, NY 10032, USA 2 Department of Biomedical Engineering ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3950-2860","authenticated-orcid":false,"given":"Jonathan A.","family":"Reimer","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center, New York, NY 10032, USA 1 Department of Surgery ,"},{"name":"Columbia University, New York, NY 10032, USA 2 Department of Biomedical Engineering ,"},{"name":"Mount Sinai Hospital, Chicago, IL 60608, USA 3 Department of Surgery ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1759-1145","authenticated-orcid":false,"given":"Meghan R.","family":"Pinezich","sequence":"additional","affiliation":[{"name":"Columbia University, New York, NY 10032, USA 2 Department of Biomedical Engineering ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5854-0761","authenticated-orcid":false,"given":"Maria R.","family":"Hudock","sequence":"additional","affiliation":[{"name":"Columbia University, New York, NY 10032, USA 2 Department of Biomedical Engineering ,"},{"name":"Vagelos College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032, USA 4"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4023-4752","authenticated-orcid":false,"given":"Panpan","family":"Chen","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center, New York, NY 10032, USA 1 Department of Surgery ,"},{"name":"Columbia University, New York, NY 10032, USA 2 Department of Biomedical Engineering ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariya G.","family":"Morris","sequence":"additional","affiliation":[{"name":"Institute of Comparative Medicine, Columbia University Medical Center, New York, NY 10032, USA 5"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mandy L.","family":"Kain","sequence":"additional","affiliation":[{"name":"Institute of Comparative Medicine, Columbia University Medical Center, New York, NY 10032, USA 5"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9940-2610","authenticated-orcid":false,"given":"Jay S.","family":"Leb","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center, New York, NY 10032, USA 6 Department of Radiology ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8921-3445","authenticated-orcid":false,"given":"Carrie B.","family":"Ruzal-Shapiro","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center, New York, NY 10032, USA 6 Department of Radiology ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6844-209X","authenticated-orcid":false,"given":"Charles C.","family":"Marboe","sequence":"additional","affiliation":[{"name":"Columbia University Medical Center, New York, NY 10032, USA 7 Department of Pathology ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4456-4484","authenticated-orcid":false,"given":"Matthew","family":"Bacchetta","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN 37232, USA 8 Department of Thoracic Surgery ,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1801-4975","authenticated-orcid":false,"given":"N. 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