Nuttapol RittayamaiLaurent BrochardLi Ka Shing Knowledge InstituteMahidol UniversityUniversity of Toronto2018-11-232018-11-232015-01-01European Respiratory Review. Vol.24, No.135 (2015), 132-14016000617090591802-s2.0-84923914858https://repository.li.mahidol.ac.th/handle/20.500.14594/36845©ERS 2015. Acute respiratory distress syndrome (ARDS) is characterised by different degrees of severity and different stages. Understanding these differences can help to better adapt the ventilatory settings to protect the lung from ventilator-induced lung injury by reducing hyperinflation or keeping the lung open when it is possible. The same therapies may be useful and beneficial in certain forms of ARDS, and risky or harmful at other stages: this includes high positive end-expiratory pressure, allowance of spontaneous breathing activity or use of noninvasive ventilation. The severity of the disease is the primary indicator to individualise treatment. Monitoring tools such as oesophageal pressure or lung volume measurements may also help to set the ventilator. At an earlier stage, an adequate lung protective strategy may also help to prevent the development of ARDS.Mahidol UniversityMedicineArticleSCOPUS10.1183/09059180.00012414