In this focused symposium, Drs. Brian Bohner and Peter Sloane review the clinical, radiographic, pathologic and physiologic characteristics of ARDS, types of ventilator-induced lung injury (VILI) along with strategies to minimize VILI, advanced therapy for patients with severe ARDS, the diagnostic workup and management of patients with pulmonary emboli (including thrombolytic or other advanced therapy), management of pneumothorax and the difficult airway.