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ARDS is a clinical syndrome of severe dyspnoea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure. The exudative phase of ARDS is characterized by alveolar/pulmonary edema, predominantly involving dependent poions of the lung and leading to aeration & atelectasis.ARDS is associated with decreased tidal volume(6 ml/kg predicted body weight) and resulting hypoxemia. The pulmonary edema in ARDS is of noncardiogenic type with normal pulmonary aery pressure. It must be differentiated from carcinogenic pulmonary edema where pulmonary aery pressures are increased associated with changes in chest x-ray such as the presence of Kerley B lines etc. Reference: Harrison's Medicine-20th edition, page no:2031