Wu Z, Liu Y, Xu J, et al. - Among acute respiratory distress syndrome (ARDS) patients, diagnosis of ventilator-associated pneumonia (VAP) is challenging. Hence, researchers conducted a secondary analysis of patient-level data from the Early vs Delayed Enteral Nutrition (EDEN) of ARDSNet randomized controlled trials with the aim to establish an effective model to predict VAP in ARDS. The EDEN trials enrolled 1,000 unique patients, 70 of whom (7%) had ARDS complicated with VAP. Patients in the VAP group vs non-VAP group had significantly longer mechanical ventilation duration and intensive care unit (ICU) stay, however, the group were comparable concerning the 60-day mortality. Following were identified as the independent risk factors for VAP: use of neuromuscular blocking agents, severe ARDS, admission for unscheduled surgery, and trauma as primary ARDS causes. The developed model generated the area under the curve of 0.744, and showed acceptable model fit. The calibration curve suggested that the model exhibited proper discrimination and good calibration. In ARDS patients, the prediction nomogram can be applied after ICU admission, using available variables.