Backgrounds:There are very few studies in diagnosis and pattern of ARDS patients in Thaitand. The various causes reported for ARDS have been associated with a variety of tropical infections. Therefore, the aim of this study was to assess the ctinical characteristics and factors predicting outcomes among ARDS patients.Objective:To establish the clinical characteristics of ARDS and determine the effect of ARDS to organ dysfunctions, ctinicaI outcomes, prognosis among those patients.Methods:Cross-sectiona[ observational study was done over ]. year from October 2O13 to December 2014 in medical intensive care unit, Buriram hospital. Basetine characteristics, etiotogy, disease severity, length of hospital stay and mortal.ity were coLlected. Factors and severity of organ dysfunctions significantly influenced mortality were examined. Resutts:Eighty of 605 (1.3.2%) ARDS patients were enrotled. Mean age was 45.9tt5.2, 52 (65.0 were men. Mean PaO2/FiO2, uas 145.7 and severe ARDS (PaO2/FiO2< 100) was 31..3o/o. pEEp l.evel.was 8.4+ 3.2 cmH2O. Mean APACHEII was 35.1+4.5, SAPll 66.5+8.2, SOFA dayl 14.5t3.0, SOFA day3 10.8+5.1, [actate 8.9+3.8, SCVO2 75.7t1,4.4, basetine creatinine 3.8+2.4, 91.3o/o of patients were in AKIN stage lll,89.Oo/o received CRRT. Septic shock, bacterial pneumonia and tropical infections were main diagnosis causes of ARDS (3B.Bo/o, 37.2o/o and 2O.Oo/o respectivel.y). Length of hospital. stay was 12.5+11.9 days, intensive care unit stay 6.2+7.2, mechanical ventitator free day 6.3t9.0. Additionally, in hospita[ mortal.ity was 43.8o/o and 28day mortal.ity was 46.30/o. Tldat volumes in both survivor and non survivor were higher than Iung protective ventitation strategy recommendation (7.7 vs 8.5 mt/predicted body weight, respectivety, p<0.05). Putmonary comptications included diffuse putmonary hemorrhage. Moreover, patients with presenceof septic shock, lactic acidosis, muttipl.e organ faitures especiatl.y acute kidney injury had a significantl.y higher mortality rate (p<0.05). 