Prognosis of patients suffering from acute respiratory distress syndrome (ARDS) remains uncertain with mortality rate 20–60 %. Severe respiratory failure featuring profound hypoxemia resistant to conventional therapy may occur in some patients. „Rescue therapy procedures“ have been considered as treatment options mostly in experimental setting or in strictly defined and limited cohorts of patients. Selected experimental and clinical trials evaluating therapy with inhaled nitric oxide, surfactant treatment, liquid ventilation, high frequency oscillation, extracorporeal lung assisting devices and prone position are discussed.Based on currently available results,prone position and high frequency oscillatory ventilation appear to be most promising and likely to become a part of standard therapy for selected subgroups of patients in the future.

        Key words: ARDS – nitric oxide – surfactant – liquid ventilation – ECLA – HFOV – prone position