As there are no effective pharmacological therapies available, the need for translational research in ARDS is obvious. Research strategies are necessary to understand and manipulate the molecular mechanisms that lead to loss of alveolar–capillary barrier function and oedema formation. Furthermore, newer aims include strategies to repair and regenerate the injured barrier, including new cell-therapeutic approaches. Controlling epigenetic mechanisms and new inhalational approaches, including advanced aerosol techniques and nano-particles, are also attractive prospects.
Clinical research should include strategies to improve the treatment of ARDS patients in relation to ventilatory techniques, extracorporeal devices, and supportive measures. However, such studies need to be carried out on a multicentre basis in order to have the necessary statistical power for adequate evaluation of survival benefit.