What is the current thinking on how to treat someone with ards?

Low tidal volume. The ardsnet studies showed that lower tidal volumes (6ml/kg ideal body weight) coupled with lower peak pressures and increased peep resulted in improved outcomes. Several groups are looking at more advanced vent strategies but these are still in the early phases of testing.
Lung protection. Treating the cause of ARDS is paramount. Supportive measures are needed until healing. Major recent development is the lung protective strategy used, avoiding excessive pressure and volume in the lung, thus preventing additional lung injury when someone is on a breathing machine. Measures to avoid blood clots, infections and stomach ulcers also important.
Treat cause. ARDS is a kind of lung injury related usually to a underlying problem. ( for example like a serious infection, etc..) so treatment involves treating the underlying disease. Patients need life support until this is done. The patient will often need a mechanical ventilator to breath for them. They do best if the vent is set up to deliver small sized breaths at a low pressure to help the lung heal.