In particularly severe forms of ARDS, if necessary, with initial neuromuscular blockade with cisatracurium (drug from the group of non-depolarizing muscle relaxants) for 48 hours (→ reduction of 90-day mortality and total duration of ventilation)
Fluid restriction
Positioning therapy – with the upper body elevated; if necessary, intermittent prone position.
Glucocorticoids (neither low nor high dosage (caveat increased mortality (death rate)) sufficient evidence).
Substitution of synthetic, recombinant, or natural surfactant → short-term oxygenation enhancement/improvement of tissue oxygenation (no effect on lethality/mortality rate)
Β2-Receptor agonists: neither i.v. application of salbutamol nor for inhalation of albuterol showed a positive efffect.
Almitrin vasoconstrictor/vasoconstrictor agents): may improve ventilation-perfusion ratio and thus oxygenation; caveat: risk of lactic acidosis (hyperacidity due to excessively high bloodlactate levels) or liver injury.
ECMO (extracorporeal membrane oxygenation) for organ recovery (“bridge to recovery”):