Pu S, et al. - Sivelestat was assessed for its impact in patients with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). While exerting little or no impact on 28–30 days mortality, ventilation days, and ICU stays in the studied population, sivelestat therapy might increase the arterial oxygen partial pressure (PaO₂)/fractional inspired oxygen (FiO₂) level. Verification of these findings in large-scale trials is required.