Acute respiratory distress syndrome (ARDS) is a severe, life-threatening condition characterized by acute onset of hypoxemia and bilateral pulmonary infiltrates, not fully explained by cardiac failure or fluid overload. It often complicates critical illnesses such as abdominal trauma and requires prompt recognition and management to reduce morbidity and mortality. This algorithm provides a systematic approach to ARDS management in the intensive care unit (ICU), emphasizing personalized strategies based on ARDS phenotypes, evidence-based interventions, and emerging therapies [1, 2] [Ref: Algorithm 77.1].