INS and metabolic acidosis: Among the deleted variables, MBP, as a hemodynamic index, is actively regulated in the early management of ARDS, and its fluctuations are strongly influenced by fluid resuscitation and vasoactive drugs; Mean blood glucose levels were disturbed by insulin therapy, stress, and other factors; Although the anion gap may reflect metabolic acidosis, patients with ARDS are often comorbid with complex acid–base imbalances (e.g., respiratory alkalosis compensation), making it difficult to accurately assess metabolic status, and all of these metrics may weaken predictive stability.