ARDS Landmark Studies

ARDS Landmark Studies

A curated timeline of major trials and practice-changing evidence in Acute Respiratory Distress Syndrome.

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Showing 11 of 11 studies
2000
ARMA
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome
Brower RG et al. • ARDSNet • NEJM
Ventilation
Tidal VolumePlateau Pressure

Summary

Lower tidal volume ventilation (6 mL/kg) reduced mortality from 39.8% to 31.0% compared to traditional volumes.

DOI:10.1056/NEJM200005043421801
PMID:10793162
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2004
ALVEOLI
Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome
Brower RG et al. • ARDSNet • NEJM
Ventilation
PEEP

Summary

Higher PEEP did not reduce mortality compared to lower PEEP when using low tidal volume ventilation.

DOI:10.1056/NEJMoa032193
PMID:15269312
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2006
FACTT
Comparison of two fluid-management strategies in acute lung injury
Wiedemann HP et al. • ARDSNet • NEJM
Fluid Therapy
ConservativeLiberalHemodynamics

Summary

Conservative fluid management improved oxygenation and reduced ventilator days without affecting mortality.

DOI:10.1056/NEJMoa062200
PMID:16714767
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2013
OSCILLATE
High-frequency oscillation in early acute respiratory distress syndrome
Ferguson ND et al. • Canadian Critical Care Trials Group • NEJM
Ventilation
HFOV

Summary

HFOV increased mortality compared to conventional ventilation. Trial stopped early for harm.

DOI:10.1056/NEJMoa1215554
PMID:23339639
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2010
ACURASYS
Neuromuscular blockers in early acute respiratory distress syndrome
Papazian L et al. • French ICU Group • NEJM
NMBASedation
CisatracuriumDeep Sedation

Summary

Early neuromuscular blockade improved 90-day survival and increased ventilator-free days in severe ARDS.

DOI:10.1056/NEJMoa1005372
PMID:20843245
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2013
PROSEVA
Prone positioning in severe acute respiratory distress syndrome
Guérin C et al. • French ICU Network • NEJM
Prone Position
Oxygenation

Summary

Prone positioning reduced 28-day mortality from 32.8% to 16.0% in severe ARDS patients.

DOI:10.1056/NEJMoa1214103
PMID:23688302
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2017
ART
Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs Low PEEP on Mortality in Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial
Cavalcanti AB et al. • Brazilian Research Network • JAMA
Ventilation
Recruitment ManeuversPEEP

Summary

Lung recruitment with PEEP titration increased mortality compared to low PEEP. Aggressive recruitment not recommended.

DOI:10.1001/jama.2017.14171
PMID:28973363
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2019
ROSE
Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome
Moss M et al. • NHLBI PETAL Network • NEJM
NMBASedation
CisatracuriumLight Sedation

Summary

No mortality benefit from early neuromuscular blockade, contradicting earlier ACURASYS findings.

DOI:10.1056/NEJMoa1901686
PMID:31112383
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2018
EOLIA
Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome
Combes A et al. • International ECMO Network • NEJM
ECMO
VV-ECMO

Summary

ECMO did not significantly reduce 60-day mortality, but may benefit patients with refractory hypoxemia.

DOI:10.1056/NEJMoa1800385
PMID:29791822
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2020
RECOVERY
Dexamethasone in Hospitalized Patients with Covid-19
Horby P et al. • UK RECOVERY Collaborative Group • NEJM
CorticosteroidsCOVID-19
DexamethasoneSARS-CoV-2

Summary

Dexamethasone reduced 28-day mortality in patients requiring respiratory support. Became standard of care.

DOI:10.1056/NEJMoa2021436
PMID:32678530
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2025
Early versus late 2 mg/kg methylprednisolone therapy in ARDS
Verchère J et al. • GRAM+ Marseille Study Group • Scientific Reports
Corticosteroids
Methylprednisolone

Summary

No significant difference in mortality between early (≤14 days) vs late (>14 days) initiation of 2 mg/kg methylprednisolone in ARDS. Late initiation may be associated with more complications.

DOI:10.1038/s41598-025-22142-8
PMID:41174150
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