Severe acute respiratory distress syndrome (ARDS) is one of the serious complications in critically ill neonates. It can result in severe hypoxemia refractory to mechanical ventilation. Usually, invasive ventilation with low parameters is enough for neonates with mild and moderate ARDS. And Extracorporeal membrane oxygenation（ECMO）is used to neonates with severe ARDS. However, ECMO can also lead to high death rate and need more technique and conditions. Mechanical ventilation with higher parameters was a substitute for such situations, but the death rate, complications and injuries of higher parameters is unknown. The aim of the present study is to explore whether mechanical ventilation can decrease the mortality and other sequelae in neonate with severe ARDS.