Kotok D, Yang L, Evankovich JW, et al. - In this study with patients experiencing Acute Respiratory Distress Syndrome (ARDS), researchers utilized chest X-rays (CXR) to analyze the longitudinal evolution of radiographic edema in this patient group, as well as to assess its link with prognostic biomarkers, ARDS subphenotypes, and outcomes. They applied the Radiographic Assessment of Lung Edema (RALE) score on the participants. This study also included patients with cardiogenic pulmonary edema as controls. Findings revealed good inter-rater agreement of the RALE score applied on 488 CXRs from 129 patients; patients with ARDS (n = 108) vs controls (n = 21) showed higher RALE scores. Experts noted a positive correlation of baseline RALE scores with levels of the receptor for end-glycation end products among ARDS patients. Thirty- or 90-day survival was not predicted by baseline RALE scores. Findings highlighted that the RALE score was readily implemented and displayed high inter-rater reliability. To track the evolution of radiographic edema in ARDS cases, longitudinal RALE scoring seemed to be a reproducible method, which can also potentially predict the prolonged requirement for mechanical ventilation.