PLAT and acute respiratory distress syndrome: The authors suggest that there is a precedent for increasing the dose of the bolus of tPA while maintaining heparin infusion, as the anticoagulant is effective against sub‐massive pulmonary embolism.83., 84. In addition to readdressing the fibrinolytic balance, administration of tPA to ARDS patients may confer anti‐inflammatory effects, as it has been shown to suppress neutrophil activation in a rat model of ALI induced by IL‐1α.85