This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The incidence of ALI is higher than previously recognized and the number of survivors is growing due to improving ICU mortality and an aging population at risk for ALI. However, these survivors endure many long-term morbidities. To date, the vast majority of clinical trials in ALI have not considered these long-term outcomes, instead focusing exclusively on short-term mortality-based end points. To advance this field, larger-sized longitudinal studies are needed to comprehensively understand the long-term physical, cognitive and mental health status of survivors and to test how specific ICU therapies may affect these outcomes. Our proposal makes the following important contribution: in-depth clinical evaluation of muscle strength, anthropometrics and cognition which have been incompletely evaluated in prior studies but are likely commonly and severely impaired in survivors, and potentially improved by the ICU therapies tested in the parent trials.