LIPS-A: Lung Injury Prevention Study With Aspirin

Inclusion Criteria: * Adult patients (age \> 18) admitted to the hospital through the emergency department (ED) * At high risk of developing acute lung injury (ALI) Lung Injury Prediction Score (LIPS) greater than or equal to 4 Exclusion Criteria: * Anti-platelet therapy on admission or within 7 days prior to admission * Presented to outside hospital ED \> 12 hrs before arrival at site's facility * Inability to obtain consent within 12 hours of hospital presentation * Admitted for elective surgery * Acute lung injury prior to randomization * Receiving mechanical ventilation through a tracheostomy tube prior to current hospital admission (patient who is ventilator dependent) * Presence of bilateral pulmonary infiltrates on admission if he or she has a history of bilateral pulmonary infiltrates (as evidenced by previous x-rays) that can reasonably explain the current degree of pulmonary infiltrates present. * Presentation due to pure heart failure and no other known risk factors for ALI. * Allergy to aspirin or non steroidal anti inflammatory drugs (NSAIDs) * Bleeding disorder * Suspected active bleeding or judged to be at high risk for bleeding * Active peptic ulcer disease (within past 6 months) * Severe chronic liver disease * Inability to administer the study drug * Expected hospital stay \< 48 hours * Admitted for comfort or hospice care * Patient, surrogate or physician not committed to full support. (Exception: a patient will not be excluded if he/she would receive al…