Acute respiratory distress syndrome (ARDS) occurs when blood oxygen levels drop too low because fluid has accumulated in the lungs. Numerous medical conditions, both acute and chronic, can cause ARDS. Often, a first responder or doctor hears wheezing or crackling sounds coming from the lungs. When the lungs are clear, this usually signals a hematologic, metabolic, or obstructive process. Here’s what you need to know about diagnosing and treating the cause.