Figure 1.

Flow diagram of study population and analyses. Patients were excluded from the acute respiratory distress syndrome (ARDS) recognition analysis if they met the American-European Consensus Conference (AECC) ARDS definition but did not receive mechanical ventilation (n = 38) to allow a more homogeneous analysis of clinician-recognition of ARDS (CR-ARDS) across time and different ARDS definitions (AECC and Berlin). In the analysis of CR-ARDS on ventilator management, we excluded patients without ARDS (n = 596). Finally, in the fluid management analyses, we excluded patients who received either continuous bladder irrigation (n = 3) or renal replacement therapy (n = 77) while in the ICU. Further details and rationale are provided in the Supplementary Methods (http://links.lww.com/CCX/A687).