The association of ARDS with bone demineralization is physiologically plausible: ARDS results in systemic release of inflammatory cytokines [19] such as interleukin-6 [20], TNFα [20,21], interleukin-1 [21] and interleukin-8 [22], which stimulate osteoclastogenesis and bone resorption with calcium mobilized into the circulation from these bone stores [23]. This evidence concerns the gene TNF and acute respiratory distress syndrome.