BACKGROUND:This meta-analysis of randomized controlled trials aimed to systematically evaluate the value of albuterol in the treatment of patients with acute respiratory distress syndrome (ARDS).DATA SOURCES: Randomized controlled trials on albuterol treatment of ARDS from its inception to October 2014 were searched systematically. The databases searched included: PubMed, Ovid EMBASE, Ovid Cochrane, CNKI, WANFANG and VIP. The trials were screened according to the pre-designed inclusion and exclusion criteria. We performed a systematic review and meta-analysis of the randomized controlled trials (RCTs) on albuterol treatment, attempting to improve outcomes, i.e. lowering the 28-day mortality and ventilator-free days.RESULTS: Three RCTs involving 646 patients met the inclusion criteria. There was no signifi cant decrease in the 28-day mortality (risk difference=0.09; P=0.07, P for heterogeneity=0.22, I 2 =33%). The ventilator-free days and organ failure-free days were signifi cantly lower in the patients who received albuterol (mean difference=-2.20; P<0.001, P for heterogeneity=0.49, I 2 =0% and mean difference=-1.71, P<0.001, P for heterogeneity=0.60, I 2 =0%).CONCLUSIONS: Current evidences indicate that treatment with albuterol in the early course of ARDS was not effective in increasing the survival, but signifi cantly decreasing the ventilator-free days and organ failure-free days. Owing to the limited number of included trails, strong recommendations cannot be made.