A large variety of inflammatory mediators (Table 1) have been found to be elevated in the early phase of ARDS, including lung-specific proteins, endotoxin binding proteins, tumor necrosis-alpha (TNFa), interleukins – (ILs) – 1, 2, 6, 8, 15, chemokines, ferritin, markers of endothelium activation (adhesive molecules and von-Willebrand factor antigen-VWF) as well as markers of neutrophil activation such as matrix metalloproteinases (MMPs) and their inhibitors and leukotrienes [5-7]. Here, TNF is linked to acute respiratory distress syndrome.