Interestingly, considering our data, our findings suggest that TH could be also beneficial under these impaired surfactant conditions: (1) at lower concentration, as in the ARDS, surfactant performance is better at 33 °C than 37 °C (Fig. 1), (2) surfactant exhibits higher resistance to plasma inhibition under TH (Fig. 4); (3) due to the lower miscibility of lipids at 33 °C, unsaturated lipids (e.g. puPC and DOPC) and plasma components are removed more efficiently from the interface. This evidence concerns the gene TH and acute respiratory distress syndrome.