Changes in care, including ventilatory strategies within acute respiratory distress syndrome (ARDS), bundled actions decreasing central-line infections, and goal-directed responses to sepsis, have been associated with improved outcomes for patients; yet, there have not been similar improvements seen in critically ill patients undergoing trials of corticosteroids, aspirin, statins, growth factors, activated protein C, stem cells, as well as vitamins C and D (Matthay et al., 2017; François et al., 2016; Vincent and Creteur, 2015). This evidence concerns the gene PROC and acute respiratory distress syndrome.