A subsequent study on pigs randomized to mechanical ventilation-induced ARDS versus hypoxia-only groups found greater cognitive impairment and trends toward increased hippocampal inflammation and systemic IL-6 and TNF-α expression among ARDS subjects, further corroborating the distinct pathophysiological roles of mechanical ventilation and concomitant cytokine release [51]. This evidence concerns the gene IL6 and acute respiratory distress syndrome.