PROC and acute respiratory distress syndrome: Despite multiple trials looking at the utilization of pharmacologic approaches to reducing sepsis-induced secondary organ injury such as acute respiratory distress syndrome (ARDS) and acute kidney injury, there is either conflicting evidence as in the case of glucocorticoids [20] or no evidence of benefit in the cases of ketoconazole [21], activated protein C [22], and n-acetylcysteine [23,24].