Human Mesenchymal Stem Cells For Acute Respiratory Distress Syndrome

Inclusion Criteria:

Patients will be eligible for inclusion if they meet all of the below criteria. Criteria 1-3 must all be present within a 24-hour time period and at the time of enrollment:

Acute onset (defined below) of:

1. A need for positive pressure ventilation by an endotracheal or tracheal tube with a PaO2/FiO2 ratio < 200 with at least 8 cm H2O positive end-expiratory airway pressure (PEEP)
2. Bilateral infiltrates consistent with pulmonary edema on frontal chest radiograph
3. No clinical evidence of left atrial hypertension for bilateral pulmonary infiltrates.

Exclusion Criteria:

1. Age less than 18 years
2. Greater than 96 hours since all inclusion criteria met
3. Pregnant or breast-feeding
4. Prisoner
5. Presence of any active malignancy that required treatment within the last 2 years or other irreversible disease or condition for which 6-month mortality is estimated to be greater than 50%
6. Moderate to severe liver failure (Childs-Pugh Score > 12)
7. Severe chronic respiratory disease with a PaCO2 > 50 mm Hg or the use of home oxygen
8. 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).
9. Major trauma in the prior 5 days
10. No consent/inability to obtain consent
11. Moribund patient not expected to survive 24 hours
12. WHO Class III or IV pulmonary hypertension
13. Documented deep venous thrombosis or pulmonary embolism within past 3 months
14. No arterial line/no intent to place an arterial line
15. No intent/unwillingness to follow lung protective ventilation strategy or fluid management protocol