Acute Respiratory Distress Syndrome can be caused by a number of things, these are the most common. Pneumonia is probably the most common, severe bleeding or injury to the head or chest can lead to ARDS. When you inhale excessive amounts of smoke or chemicals you may be diagnosed with ARDS. The inhalation of vomit can lead to ARDS along with near drowning episodes. For example, being caught or stuck inside of a burning building can and may lead to ARDS because of the excessive amount of smoke you are breathing in. There are many causes but these are just a few of them.