[Acute respiratory distress syndrome-quo vadis : Innovative and individualized treatment approaches].

Acute respiratory distress syndrome (ARDS) is a heterogeneous clinical syndrome characterized by variable pathophysiology and different therapeutic approaches. Recent guidelines emphasize the importance of prone positioning and venovenous extracorporeal membrane oxygenation (VV-ECMO) for the most severe cases, while routine recruitment maneuvers and extracorporeal CO2-removal techniques are no longer recommended. To further advance the personalization of ARDS therapy, the identification of ARDS phenotypes using latent class analysis offers promising approaches for individualized treatment. Additionally, adaptive platform trials and artificial intelligence (AI)-driven decision-support systems may optimize future ARDS management. The future of ARDS treatment is becoming increasingly individualized, based on improved patient stratification, innovative study designs, and the targeted use of modern technologies. This article summarizes recent developments in ARDS therapy, particularly regarding personalized treatment strategies, new study designs, and the application of artificial intelligence.