“…ALI after burns is a common and serious complication of burns, and its mechanisms are complex and varied: (1) Burns lead to direct tissue destruction and necrosis, releasing large amounts of intracellular and extracellular biologically active molecules, such as cytokines, inflammatory mediators, and oxygen free radicals [ 28 ], these substances activate immune cells and other inflammatory mediators, causing an inflammatory response in the lungs; (2) After burns, the body undergoes a systemic inflammatory response, prompting the release of inflammatory mediators such as interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in the bloodstream, and these inflammatory mediators can spread rapidly through the bloodstream to the lungs, activating inflammatory cells in the lungs and leading to inflammatory reactions in the lung tissue [ 29 ]; (3) Burns cause damage to the vascular endothelium and an increase in vascular permeability, leading to impaired pulmonary microcirculation, which can cause leakage of intravascular fluid and the formation of pulmonary edema, as well as making it easier for inflammatory mediators to penetrate into the lung tissue [ 30 ]; (4) Burns cause the generation of oxygen free radicals, a highly reactive class of oxidizing molecules produced during tissue hypoxia and reperfusion, which exacerbate the inflammatory response and cause direct damage to cellular and tissue structures [ 31 ]; (5) alveolar surface-active substances (ASASs) are lubricants that help prevent alveolar collapse, and in ALI, inflammation and edema may lead to disruption of ASASs, which may in turn affect respiratory function; (6) in ALI, epithelial and endothelial cells may undergo apoptosis, a controlled process of cell death, and apoptosis may damage lung structures and cause an inflammatory response; (7) The immune system may be abnormally activated in ALI, leading to an excessive inflammatory response and damage to lung tissue. ALI after burn injury is a complex pathophysiologic process that includes direct thermal traumatic effects and a systemic inflammatory response [ 32 , 33 ]. Together, these factors lead to lung inflammation, edema, microthrombosis, and tissue damage, ultimately triggering ALI (Fig.…”