HMMM
Handy Medical Math Machine

ARDS (Acute Respiratory Distress Syndrome)

Source: ATS/ESICM Clinical Practice Guideline 2024, 2024 Global Definition of ARDS · Last reviewed: Jul 2026

1
Diagnosis

Acute onset (<1 week), bilateral infiltrates, hypoxaemia. The 2024 global definition broadens criteria — patients on HFNC/oxygen mask (without intubation) can also be diagnosed.

2
Protective Ventilation (if intubated)

Tidal volume 4–8 mL/kg predicted body weight. Keep plateau pressure <30 cmH₂O. Avoid prolonged high-pressure recruitment manoeuvres.

3
Decision

Moderate–severe ARDS (PaO₂/FiO₂ <150)?

Yes → prone positioning, sessions >12 h/day (ideally ≥16 h continuous). No → continue standard protective ventilation.

Adjunctive Therapies

Consider: corticosteroidsConsider: VV-ECMO (selected severe cases)Not routine: HFOVNot routine: inhaled NO
Summary of key principles, not a full ventilator protocol (PEEP titration, driving pressure need individual adjustment).