TNF and acute respiratory distress syndrome: Furthermore, Ranieri et al. [50] found in previous experimental findings in patients with ARDS, that the levels of tumor necrosis factor-alpha (TNFα), interleukin-6 (IL-6), and IL-8 in bronchoalveolar lavage (BAL) were lower with a ventilatory strategy titrated for optimal positive end-expiratory pressure (PEEP) and low tidal volumes than with a strategy that used high tidal volumes.