Acute Respiratory Distress Syndrome: Current and Emerging Approaches to Lung Protection.

Acute respiratory distress syndrome (ARDS) is a heterogeneous condition characterized by diverse etiologies, pathophysiological mechanisms, and variable responses to treatment. Although lung-protective ventilation has improved survival, overall outcomes remain limited. Increasing evidence supports a transition from uniform management toward individualized strategies informed by ARDS subphenotypes, imaging-based lung morphology, and biological markers. Advances in ventilatory modes, physiologic and biological subphenotyping, and multiomics technologies are expanding the potential for precision medicine in ARDS. Personalizing mechanical ventilation according to disease phase, lung recruitability, and patient-specific characteristics may enhance clinical outcomes while reducing ventilator-induced lung injury.