Please select the eligibility criteria that correspond to the clinical trial below.
Title: Lung Imaging for Ventilatory Setting in ARDS
Brief Summary: To compare in ARDS patients 2 ventilatory Strategies : One based on Lung Morphology (Focal versus non-Focal ARDS) versus ARDS networks Guidelines (PEEP based on FiO2). In Focal ARDS prone position will be promote early, with low PEEP and moderate Vt. In non-Focal ARDS, Recruitment maneuvers, high PEEP and low V twill be used.

The investigators made the hypothesis that ventilation according to Lung morphology my decrease mortality at D90.


Options:
A: Inclusion Criteria:

* All patients admitted to the participating ICUs receiving invasive or non-invasive ventilation will be screened and included in the database.

Exclusion Criteria:

* Age \< 16
B: Inclusion Criteria:

* Patients receiving mechanical ventilation will be enrolled if they meet criteria for acute respiratory distress syndrome, with the PaO2/FiO2 ratio criterion modified as follows:

  * PaO2/FiO2 ratio ≤ 200 with 5 ≤ PEEP ≤ 10 cmH2O

Exclusion Criteria:

* Age \< 16 years.
* \> 72 hours since all inclusion criteria are met.
* Lung transplant, liver transplant or bone marrow transplant.
* Clinical or instrumental evidence of cerebral edema or elevated endocranial pressure.
* Conditions which are thought to contraindicate the use of prone positioning (i.e., not-stabilized bone fracture, column fracture, pelvis fracture, multiple rib fracture with chest-wall instability, severe haemodynamic instability).
C: Inclusion Criteria:

* Man or female older than 18 years
* ARDS since less than 12 hours
* PaO2 / FiO2 \< 200 avec une PEEP ≥ 5 (Berlin Moderate or severe)

Exclusion Criteria:

* brain injury with high ICP
* BMT Liver Cirrhosis Child C Pregnancy Burns Morbid obese patients (BMI \> 40) Moribund
D: Inclusion Criteria:

* Acute onset of respiratory failure, with fewer than 2 weeks of new pulmonary symptoms;
* Endotracheal intubation or tracheostomy;
* Hypoxaemia - defined as a partial pressure of oxygen in arterial blood (PaO2)/fraction of inspired oxygen (FiO2) less than or equal to 200mmHg on FiO2 greater than or equal to 0.5, regardless of positive end expiratory pressure (PEEP)
* Bilateral alveolar consolidation (airspace disease) seen on frontal chest radiograph

In addition, to qualify for randomization, patients are assessed on the following ventilator settings:

* Mode: pressure control or volume control or pressure support
* FiO2 greater than 0.6 (or higher if necessary to keep pulse oximetric saturation \[SpO2\] greater than 90%)
* PEEP greater than 10 cm H2O (or greater if necessary to keep SpO2 greater than 90%)
* Tidal volume 6 ml/kg predicted body weight (PBW)

After at least 30 minutes on these settings, we sample arterial blood to assess oxygenation. If PaO2 is less than or equal to 200 mmHg, the patient qualifies for randomization; if PaO2/FiO2 greater than 200 mmHg, standardized hypoxaemia assessments are repeated at least once daily for the following 72 hours (providing eligibility criteria are still met).

Exclusion Criteria:

* Remaining duration of mechanical ventilation less than 48 hours, as judged by the attending physician
* Primary cause of acute respiratory failure judged by attending physician to be circulatory overload due to, for example, congestive heart failure, hyper-resuscitation, or need for dialysis
* Suspected pulmonary haemorrhage syndrome
* Lack of commitment to ongoing life support (note that this does not include the presence of a "Do Not Resuscitate" order alone, if there is a commitment to ongoing life support
* Aged less than 16 years or greater than 85 years
* Weight less than 35 kg
* Severe chronic respiratory disease, as indicated by any of:
* Baseline forced expiratory volume in one second (FEV1) less than 20 ml/kg predicted body weight
* Pre-existing chronic interstitial lung disease with chronic interstitial infiltration on chest x-ray
* Documented chronic carbon dioxide (CO2) retention (partial pressure of carbon dioxide in arterial blood \[PaCO2\] less than 50 mmHg) and/or chronic hypoxaemia(PaO2 less than 55 mmHg on FiO2=0.21)
* Chronic restrictive, obstructive, neuromuscular, chest wall or pulmonary vascular disease resulting in severe exercise restriction (e.g., unable to climb stairs or perform household duties), secondary polycythaemia, severe pulmonary hypertension (mean pulmonary arterial pressure \[PAP\] greater than 40 mmHg), or ventilator dependency
* Morbid obesity - defined as greater than 1 kg/cm body height
* Underlying pre-existing condition with expected 6-month mortality greater than 50%
* Neurological conditions with risk of intracranial hypertension (where hypercapnia should be avoided)
* Neuromuscular disease that will result in prolonged need for mechanical ventilation, including (but not limited to):
* Guillain Barre syndrome
* Cervical spinal cord injury
* Previous randomization in this trial
* All inclusion criteria present for greater than 73 hours in study intensive care unit (ICU)
* On HFO at the time of screening

Answer: C