No abstract available. Article truncated after 150 words. The Berlin definition of ARDS is: bilateral radiographic opacities (not effusion, atelectasis or nodules) of <1 week duration, not fully explained by cardiac failure or fluid overload, associated with PaO2/FiO2 <300 (1). This definition is highly inclusive. A recent international epidemiologic study showed that ARDS accounts for 10% of ICU admissions and about a quarter of patients requiring mechanical ventilation. ARDS is often undiagnosed and undertreated (2). Survival is associated with PaO2/FiO2 ratio and is 45% in patients with P/F <100 (1,2). Banner Health is embarking on a quality improvement effort focused on management of patients with ARDS and the aim of our journal club was to develop an evidence-based clinical practice for ARDS. We reviewed what we considered the ten most influential articles regarding ARDS published since 2000. We did not include interventions for which no benefit in important clinical outcomes has been demonstrated (for instance, the choice of …