Thrombocytopenia (PLT) as an independent predictor may influence ARDS progression through dual mechanisms: impaired endothelial repair due to platelet deficiency exacerbates alveolar-capillary leakage, while platelet-derived mediators such as serotonin and PF4 directly enhance pulmonary vasoconstriction and neutrophil extracellular trap (NET) formation [40]. This evidence concerns the gene PF4 and Thrombocytopenia.