Luo J, et al. - Early recognition of risks for acute respiratory distress syndrome (ARDS) from severe pneumonia is of great clinical value. In this study, it was demonstrated that positive end-expiratory pressure (PEEP) >6.5 cmH2O and serum fibrinogen (FiB) >5.15 g/L could early detect ARDS development risk in severe pneumonia patients. In addition, pH <7.35 represented a reliable prognostic factor in predicting ARDS mortality risk.