Objective To enhance the clinical understanding of the diagnosis and treatment of acute respiratory distress syndrome (ARDS) caused by severe pulmonary contusion in multiple trauma patients.Method 18 cases of severe pulmonary contusion complicated with ARDS were retrospectively reviewed.All the patients underwent mechanical ventilation with SIMV+PSV+PEEP mode and clinical data such as SpO₂,PaO₂,PaCO₂,PaO₂/FiO₂ and vital signs were collected and analyzed.Result Of them,18 cases of severe pulmonary contusion,15 were fully recovered and 3 died; pulmonary infection was seen in 8 cases.Our data showed a significantly improvement of patients’ clinical status after initiation of the mechanical ventilation,with increased PaO₂,PaCO₂,PaO₂/FiO₂ (P<0.01) and SpO₂ (P<0.05) and reduced HR (P<0.01).Conclusion Mechanical ventilation with appropriate PEEP is an effective therapeutic method for severe pulmonary contusion complicated with ARDS.