Background: Management and therapeutic options for ARDS Although there have been huge advances in the overall management of patients with ARDS since Ashbaugh first described it in a Lancet publication in 1967, many controversial aspects concerning the pathogenesis, diagnosis, therapeutic options, and supportive measures for this condition still exist. The effectiveness of ARDS management strategies is influenced by several factors, including the underlying cause of ARDS (pulmonary or extrapulmonary), the stage of the disease (early or late), the patient's general health status, and the occurrence of complications such as multiple organ dysfunction syndrome (MODS), infection, and barotrauma. While these factors can impact treatment response, none of them can reliably predict patient outcomes or definitively distinguish responders from non-responders. Moreover, ARDS is a self-limiting disease, and the primary goal of treatment is to provide time for the lungs to heal naturally or for specific therapies to take effect