Acute Respiratory Distress Syndrome (ARDS) is a severe lung condition that makes it hard to breathe. In this study, researchers are testing if therapeutic hypothermia (TH), which cools the body to protect the lungs, helps people with ARDS. A medicine called neuromuscular blocking agents (NMBA) is used to stop shivering during the cooling. The study compares this treatment to usual care to see which works better.

Patients will be in the study for about 54 hours, with follow-up checks until day 28 and phone calls on days 60 and 90. The main goal is to see if patients can breathe without a ventilator for more days within 28 days. The study will also check safety and other health measures.

• Length: 54 hours for the main treatment, with check-ups until day 28.
• Visits: Regular checks and phone follow-ups needed.
• Risks: May include shivering, cooling complications, or others.

Patients from 14 hospitals, including those with ARDS due to COVID-19, can join if they meet the study's conditions. This study is funded by the Department of Defense and hopes to find a new way to help people with ARDS breathe better.