ARDS is a syndrome that appears to be under recognized, undertreated, and associated with a high mortality rate. ARDS is a progressive process with an early treatment window that can be exploited. 
ARDS – the clinical challenge
Acute respiratory distress syndrome (ARDS) is a serious lung condition that causes low blood oxygen. The global burden of ARDS has been estimated to be in excess of 3 million patients per year.
Mortality for severe ARDS was reported at 46.1% in an observational study that included 459 ICUs across 50 countries. In the US, ARDS affects approximately 200,000 people and results in 74,500 deaths annually.
Where are the causes?
ARDS is a syndrome, that means that is presented with signs and symptoms that can be caused by several different diseases. It is a serious condition, meaning that usually severe pathologies can lead to ARDS, such as severe trauma, serious infections or grave inflammatory conditions.
ARDS has been defined by an expert consensus in Berlin, as an acute (less than one week) hypoxic respiratory failure (PaO2/FiO2 < 300 mmHg) that lead to bilateral lungs infiltrates and that cannot be reasonably explained by pulmonary edema, pleural effusions or nodules.
A sample treatment algorithm for adults with ARDS begins with treatment of the underlying cause, but optimisation of mechanical ventilation is key to lungs recovery and reduction of complications. Treatment plans must be individualized to the cause and available interventions at the treating facility. 
The COVID-19 pandemic has seen a surge of patients with acute respiratory distress syndrome (ARDS) in intensive care units across the globe.