Acute respiratory distress syndrome (ARDS) is a common critical illness in the intensive care unit (ICU). Although many studies have been performed to explore the diagnostic and therapeutic methods for ARDS, its mortality rate is still as high as 40%. Mechanical ventilation guided by the lung protective strategy is still the cornerstone of ARDS treatment. Maintaining moderate spontaneous breathing during mechanical ventilation in ARDS patients is helpful to lung recruitment, oxygenation improvement, diaphragm dysfunction prevention and so on. By combining with effective monitoring techniques, setting appropriate mechanical ventilation modes and parameters to assist patients in maintaining well-tolerated spontaneous effort and prevent patient-self inflicted lung injury (P-SILI) may be important for the lung protective strategy.