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1 Introduction Acute respiratory distress syndrome (ARDS) is a severe, life-threatening inflammatory condition of the lungs commonly triggered by infections such as bacterial pneumonia, viral pathogens (e.g., influenza and SARS-CoV-2), and systemic sepsis ( The pathogenesis of ARDS involves an exaggerated immune response that damages alveolar structures, disrupts the alveolar-capillary barrier, and promotes excessive inflammation, vascular leakage, and oxygenation failure ( Regulated cell death pathways, such as apoptosis, pyroptosis, necroptosis, and ferroptosis, play pivotal roles in controlling inflammation and maintaining tissue integrity

Cyanocobalamin | Drugs | BNF

Pain 159 , 469480 (2017)

This makes it more challenging to determine both efficacy and safety