Evolving definition of acute respiratory distress syndrome

Acute respiratory distress syndrome (ARDS) accounts for more than 10% of ICU admissions and involves almost a quarter of patients requiring mechanical ventilation (1). Despite several decades of research and progress, particularly regarding mechanical ventilation, ARDS remains associated with high mortality. In the absence of gold standard for its diagnosis, ARDS recognition depends on the use of a reliable definition. Definition of ARDS evolved step by step by improving understanding pathophysiology (2) and ventilator management (3).