Understanding and managing acute respiratory distress syndrome (ARDS): New pharmacological approaches reviewing recent developments in the pharmacological management of ARDS

Abstract

Acute respiratory distress syndrome (ARDS) remains a major cause of morbidity and mortality in critical care, characterized by severe inflammation, endothelial damage, and impaired gas exchange. This review explores the current and future pharmacological approaches to ARDS management. Present standard care includes mechanical ventilation strategies, adjunctive therapies such as extracorporeal membrane oxygenation and prone positioning, and pharmacological interventions such as corticosteroids and neuromuscular blockers. However, treatment challenges, including the heterogeneity of ARDS and adverse effects of current therapies, have driven the need for new approaches. Emerging pharmacological options, including biologics, endothelial stabilizers, and mesenchymal stem cell therapies, aim to target the underlying pathophysiology more precisely. Advances in pharmacogenomics and personalized medicine promise to optimize treatment by identifying genetic susceptibilities and using biomarker-guided therapies. Ongoing clinical trials and exploration of gene therapies offer additional hope for modifying ARDS at a molecular level. In addition, AI and big data are being integrated to enhance precision medicine and optimize patient outcomes. These innovations represent a paradigm shift in ARDS management, offering more tailored, effective treatments that could significantly reduce mortality and improve longterm outcomes.