Investigators are extending the scope of feasible therapeutic approaches to patients with acute pulmonary edema or acute respiratory distress syndrome. With the recognition of the complex pathophysiology of acute respiratory distress syndrome and the identification of numerous mediators, avenues of research have opened up leading to the exploration of potential therapies. Neutrophil elastase and arachidonic acid metabolites are mediators that, if effectively inhibited, could mitigate acute injury. Repletion of antioxidants and surfactant might also be of benefit. We continue to understand more fully the potential of inhaled nitric oxide to improve the detrimental vascular response seen in acute respiratory distress syndrome, and newer approaches to mechanical ventilation continue to be studied as we become cognizant of volutrauma. Other studies are identifying means to increase lung edema clearance. We provide here a synopsis of the research in these areas occurring in the past year.