Recommendation: We suggest using NPPV for early respiratory management in adults with ARDS. (GRADE 2C,Strength of recommendation “weak recommendation” / Quality of evidence: ”low”)

●Supplementary conditions: Monitor the patient for clinical improvement within 1-2 hours of initiating NPPV. Then confirm whether the patient’s respiratory status meets a predefined goal set prior to initiating NPPV within 4-6 hours. Many RCTs exclude unconscious patients and hemodynamically unstable patients. Applying this recommendation requires caution in these populations [32].