In ALI, the lung epithelium upregulates TF mRNA, protein and procoagulant activity [10] and releases TF positive procoagulant microparticles [15] leading to a shift towards procoagulant pathways in the airspace that are not balanced by anticoagulant pathways such as tissue factor pathway inhibitor (TFPI) [16]. This evidence concerns the gene TFPI and acute respiratory distress syndrome.