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ARDS — low tidal volume ventilation; lung protective. ICU: ventilator (modes — AC — full; SIMV — sync; PSV — spontaneous; PEEP — recruit: ARDS — 6mL/kg — low — permissive hypercapnia; wean — SBT — T-piece), sedation (propofol — short; dexmedetomidine — delirium — less; daily interruption — assess), sepsis (bundle — cultures — antibiotics <1h — fluids 30mL/kg — vasopressors — norepinephrine; lactate), VAP (prevent — head-up 30°, oral care, subglottic suction). The ARDS lung needs low volumes — 6mL/kg.