Curosurf® in Adult Acute Respiratory Distress Syndrome Due to COVID-19

Inclusion Criteria: * At least 18 years * Intensive care unit admission. * Intubation and mechanical ventilation since less than 72h. * Positive end-expiratory pressure ≥ 5 cmH2O. * Acute respiratory distress syndrome following Berlin definition. * COVID-19 * PaO2/FiO2 ratio \< 150 mmHg during at least 3 hours despite PEP trial. * Compliance of the respiratory system \< 50 mL/cmH2O Exclusion Criteria: * Contraindication to prone position. * Pregnancy. * Weight \< 40 kg * height \< 140 cm or height \> 190 cm. * Profuse bronchorrhea (at least 1 succion per hour during 3 hours). * Other significant cause than ARDS to the respiratory failure. * Decision to limit active therapies. * No arterial line in place. * Obesity with weight / height ratio \> 1 kg / cm. * Impossible to give neuromuscular blockers (e.g. drug unavailable owing to global pandemia). * Severe chronic respiratory failure with oxygen at home. * Other severe acute or chronic organ faillure (eg severe liver cirrhosis, severe chronic cardiac failure). * History of pneumonectomy or pulmonary lobectomy. * Patient scheduled for extracorporeal membrane oxygenation. * Known hypersensibility to Curosurf. * Contraindication to bronchial fibroscopy. * Person under legal protection.