MT-RNR1 and acute respiratory distress syndrome: Low serum MOTS-c levels at T2 predicted adverse postoperative outcomes, including a 2.8-fold higher risk of ARDS within 72 h (P = 0.003), reduced oxygenation capacity (P < 0.001), prolonged mechanical ventilation (P = 0.008), and extended hospitalization (P = 0.012), whereas serum MOTS-c levels at T1 had no ability to predict these outcomes.