A Multicentre, Prospective, Observational, 8-week Inception Cohort Study Being Carried Out by the Acute Respiratory Failure Section of China

1. The goal of this study will focus on the following items:

• The frequency and disease burden of acute respiratory failure in China;
• The incidence of ARDS based on the new global definition within this patient cohort.
• The mortality of ARDS within this cohort, and how does this vary based on ARDS categories and severity.
• The long-term outcomes (1-year mortality and survivor quality of life) of ARDS within this cohort.
• The nature course of ARDS (different stages and severity of ARDS).
• The respiratory support management strategies, such as recruitment maneuvers, prone positioning, ECCO2R, and ECMO.
• The use of drugs during ICU stays, including glucocorticoid, anticoagulant, nitric oxide, sivelestat, Xuebijing, and ulinastatin.
• The economical burden of acute respiratory failure within this patient cohort.
• The impact of occupation, incomes and education levels on the incidence and mortality of ARDS.

2. Methods 2.1 Study Design This is a national prospective observational study, aimed at collecting an adequate dataset on a large cohort of patients admitted to a large number of ICUs in China. Each ICU will be requested to recruit for 8 consecutive 'winter' weeks between January 2024 and April 2024.

2.2 Inclusion and exclusion criteria

• Inclusion criteria: All patients admitted to the participating ICU receiving invasive, non-invasive ventilation or high-flow nasal cannula (HFNC) will be screened and included in the database.
• Exclusion criteria:Age<18

3. Sample size calculation Our aim is to obtain a sample of at least 1500 ARDS patients within the cohort.