Respiratory failure on postoperative day 2. Shown is the chest X-ray with bilateral patchy opacities (black arrows) after urgent reintubation. Together with a normal left ventricular function and poor oxygenation (PaO2 60 mmHg, FiO2 0.8, Horowitz quotient of 75), an acute respiratory distress syndrome (ARDS) was diagnosed, based on the Berlin definition.