Inclusion Criteria:  Are 18 years or older Have been mechanically ventilated due to moderate ARDS for 48-120h Have a PaO2/FiO2 ratio < 200 and > 100 at the time of screening with PEEP ≥ 5 cmH2O Are expected to remain on mechanical ventilation ≥ 48 hours Are under continuous sedation with Richmond Agitation Sedation Scale (RASS) ≤ -3  Exclusion Criteria:  Septic shock with hemodynamic instability (norepinephrine or epinephrine < 0.5 gamma/kg/min) Catheter access to left subclavian vein deemed impossible Use of neuromuscular blocking agents within last 12 hours Bacteremia within the last 48 hours or uncontrolled source of infection Currently on ECMO Enrolled in any other study of an investigational drug or device, which may affect the outcomes of the current study Pre-existing neurological, neuromuscular or muscular disorder that could affect the respiratory muscles BMI >45 kg/m2 Known or suspected phrenic nerve paralysis Any electrical device (implanted or external) that may be prone to interaction with or interference from the Lungpacer PROTECT DPTS, including neurological pacing/stimulator devices and cardiac pacemakers and defibrillators No affiliation to the French health insurance system Under curatorship Imprisoned Known or suspected to be pregnant or lactating