Rationale Acute respiratory distress syndrome (ARDS) is a frequent cause of hypoxemic respiratory failure with a mortality rate of approximately 30%. The identification of ARDS phenotypes, based on focal or non-focal lung morphology, can be helpful to better target mechanical ventilation strategies of individual patients. Lung ultrasound (LUS) is a non-invasive tool that can accurately distinguish 'focal' from 'non-focal' lung morphology. The investigators hypothesize that LUS-guided personalized mechanical ventilation in ARDS patients will lead to a reduction in 90-day mortality compared to conventional mechanical ventilation.
Admitted to a participating ICU,
invasively ventilated and
fulfil the Berlin criteria for moderate or severe ARDS.
Age under 18,
participation in other interventional studies with conflicting endpoints,
conditions in which LUS is not feasible or possible (e.g. subcutaneous emphysema, morbid obesity or wounds),
mechanical ventilation for longer than 7 consecutive days in the past 30 days,