Acute respiratory distress syndrome

Acute respiratory distress syndrome, commonly abbreviated as ARDS, represents one of the most critical challenges in intensive care medicine. Characterized by rapid-onset hypoxemia and diffuse pulmonary inflammation, it often arises secondary to sepsis, pneumonia, aspiration, or trauma. Despite decades of research, mortality remains high, making advances in both understanding and treatment essential. Lung-protective ventilation strategies, with low tidal volumes and limited plateau pressures, remain foundational to minimize ventilator-induced injury. Adjunctive interventions such as prone positioning, neuromuscular blockade, and extracorporeal membrane oxygenation (ECMO) are increasingly applied in severe cases, improving survival rates in carefully selected patients. Research has identified distinct ARDS phenotypes, distinguished by inflammatory and biological profiles, creating opportunities for precision therapies tailored to patient subgroups. The COVID-19 pandemic offered unique insights, highlighting vascular injury, microthrombosis, and immune dysregulation as key drivers of disease severity. Beyond the acute phase, survivors often face long-term physical, cognitive, and psychological impairments, underlining the importance of rehabilitation, mental health support, and structured follow-up. Acute respiratory distress syndrome remains an area of active innovation, with ongoing studies exploring stem cell therapies, endothelial stabilizers, and novel anti-inflammatory agents. By combining evidence-based clinical protocols with emerging targeted interventions, the field is gradually improving outcomes while striving for more individualized and effective strategies of care.