Objective To observe the effects of different nutritional strategies on the nutritional status,inflammatory markers,and immune function of patients with acute respiratory distress syndrome(ARDS)in the intensive care unit(ICU).Methods A retrospective research method was conducted.A total of 51 ARDS patients admitted to the department of intensive care unit of Yanbian University Affiliated Hospital from March 2018 to March 2021 were selected as the study subjects.According to different nutritional regimens,patients were divided into a short peptide whole protein sequential treatment group(sequential treatment group,25 cases)and a conventional whole protein treatment group(conventional treatment group,26 cases).The differences in nutritional status indicators such as hemoglobin(Hb),prealbumin(PA),total protein(TP),albumin(ALB),inflammatory indicators such as interleukin-6(IL-6),procalcitonin(PCT),and immune function indicators such as CD3+,CD4+,and CD8+ levels were compared among ARDS patients on the 1st,5th,and 8th day of treatment.And the frequency of feeding adverse events was observed during nutritional therapy.Results On the 8th day of treatment,both PA and TP significantly increased in the sequential treatment group,which was significantly higher than that of the conventional treatment group[PA(mg/L):144.04±86.75 vs.87.15±54.88,TP(g/L):57.44±6.18 vs.52.08±6.58],the difference was statistically significant(both P<0.05).From the 5th day of treatment,the ALB in the sequential treatment group was significantly higher than that in the conventional treatment group(g/L:28.84±3.13 vs.27.07±3.05),and continued until the 8th day of treatment(g/L:30.72±4.59 vs.28.30±3.94),with statistically significant differences(both P<0.05).There was no statistically significant difference in lymphocyte count,IL-6,PCT,CD3+,CD4+,and CD8+ between the two groups,both within and between groups(all P>0.05).Both groups had gastric retention to varying degrees and used gastric motility drugs,but there was no statistical difference in the incidence of feeding related adverse events between the two groups(all P>0.05).Conclusion Early use of short peptide whole protein sequential nutrition in ARDS patients is better than simple use of whole protein enteral nutrition in correcting nutritional status,but it has no significant effect on feeding tolerance,inflammation indicators,and immune indicators.