Khemani RG, et al. - In this international, prospective, cross-sectional, observational study, researchers investigated the incidence and outcomes of children who meet the Pediatric Acute Lung Injury Consensus Conference (PALICC) definition of paediatric acute respiratory distress syndrome (PARDS). The subjects with a new diagnosis of PARDS that met PALICC criteria during the study week (10 weeks) were eligible for inclusion, and subjects meeting PARDS criteria more than 24 h before screening, having cyanotic heart disease, active perinatal lung disease, and preparation or recovery from a cardiac intervention were excluded. This study included 23,280 patients admitted to 145 paediatric intensive care units (PICUs) from 27 countries, PARDS was present in 744 (3·2%). Compared with the Berlin definition, more children were identified as having PARDS by the PALICC definition. The stratification of mortality risk was improved by PALICC PARDS severity groupings, especially when applied 6 h after PARDS diagnosis. Considering the PALICC PARDS framework for use in future epidemiological and therapeutic research among children with PARDS was recommended.