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Of 335 (29%) that received adjunctive strategies, 248 (75%) received a single strategy, and 85 (26%) receiving more than one adjunct. Of ARDS non-survivors, 67% did not receive any adjunctive strategy in the first 48 hours. Most patients (63%) receiving specialized adjuncts did not receive prone positioning or neuromuscular blockade. Patients that received adjuncts were more likely to have their ARDS recognized, be younger and sicker, have pneumonia, and be more difficult to ventilate, and be in a European high income country than those tha
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