Von Willebrand factor (VWF) is a high-molecular-weight adhesive glycoprotein that plays an essential role in primary hemostasis by promoting platelet adhesion to the subendothelium and platelet plug formation at the sites of vascular injury [50] VWF is increased in plasma and bronchoalveolar lavage (BAL) fluid of patients with acute injury and is predictive of the development of acute respiratory distress syndrome [51]. This evidence concerns the gene VWF and acute respiratory distress syndrome.