Can less fluid be more in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS)? This FACTT randomized controlled trial compared two fluid-management strategies in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS): a conservative versus a liberal fluid strategy. The conservative approach aimed to minimize fluid overload by using lower volumes of intravenous fluids, while the liberal approach allowed for more fluid resuscitation. The 60-day mortality, the primary outcome, was not different between the two groups. However, a conservative strategy resulted in improved lung function, with better lung injury scores and oxygenation indexes, and, importantly, a shorter duration of mechanical ventilation and ICU stay.