Abstract
<jats:p>Acute Respiratory Distress Syndrome (ARDS) is a severe clinical condition characterized by acute-onset hypoxemic respiratory failure, associated with high morbidity and mortality in intensive care units. Appropriate ventilatory management is one of the main pillars of treatment, with protective mechanical ventilation widely recommended to minimize ventilator-induced lung injury. This chapter aimed to analyze, through a narrative literature review, the main protective ventilation protocols used in ARDS and their implications for clinical practice. The literature search was conducted in the PubMed, SciELO, ScienceDirect, and LILACS databases, including studies published between 2015 and 2025. The results indicate that the use of low tidal volumes, strict control of alveolar pressures, and individualized adjustment of positive end-expiratory pressure contribute to reducing mortality and complications associated with mechanical ventilation. Complementary strategies, such as prone positioning, have shown additional benefits in selected cases. It is concluded that adherence to protective ventilation protocols, combined with continuous monitoring and integrated multiprofessional care, is essential for patient safety and for optimizing clinical outcomes in ARDS.</jats:p>