Acute respiratory distress syndrome diagnostic criteria: Difference between revisions
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The diagnosis of ARDS is made when the following criteria are met:<ref name="pmid22797452">{{cite journal| author=ARDS Definition Task Force. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E et al.| title=Acute respiratory distress syndrome: the Berlin Definition. | journal=JAMA | year= 2012 | volume= 307 | issue= 23 | pages= 2526-33 | pmid=22797452 | doi=10.1001/jama.2012.5669 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22797452 }} </ref> | The diagnosis of ARDS is made when the following criteria are met:<ref name="pmid22797452">{{cite journal| author=ARDS Definition Task Force. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E et al.| title=Acute respiratory distress syndrome: the Berlin Definition. | journal=JAMA | year= 2012 | volume= 307 | issue= 23 | pages= 2526-33 | pmid=22797452 | doi=10.1001/jama.2012.5669 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22797452 }} </ref> | ||
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! colspan="2" style="text-align: center;" | '''The Berlin Definition of Acute Respiratory Distress Syndrome''' | ! colspan="2" style="text-align: center;" | '''The Berlin Definition of Acute Respiratory Distress Syndrome''' | ||
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| '''Origin of edema''' | | '''Origin of edema''' | ||
| ❑ [[Respiratory failure]] not fully explained by [[Heart failure|cardiac failure]] or [[Hypervolemia|fluid overload]] <br> ❑ Need objective assessment (e.g., [[Echocardiogram|echocardiography]]) to exclude [[Pulmonary Edema|hydrostatic edema]] if no [[ | | ❑ [[Respiratory failure]] not fully explained by [[Heart failure|cardiac failure]] or [[Hypervolemia|fluid overload]] <br> ❑ Need objective assessment (e.g., [[Echocardiogram|echocardiography]]) to exclude [[Pulmonary Edema|hydrostatic edema]] if no [[#risk_factor|risk factor]] present | ||
|- | |- | ||
| colspan="2" style="text-align: left;" | '''Oxygenation''' <sup>b</sup> | | colspan="2" style="text-align: left;" | '''Oxygenation''' <sup>b</sup> | ||
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<span style="font-size: 85%;"><sup>c</sup> This may be delivered [[Positive airway pressure|noninvasively]] in the mild ARDS group.</span> | <span style="font-size: 85%;"><sup>c</sup> This may be delivered [[Positive airway pressure|noninvasively]] in the mild ARDS group.</span> | ||
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! colspan="2" style="text-align: center;" | <span id="Risk_Factor">'''Common Risk Factors for ARDS'''</span> | |||
|- | |||
| style = "width: 50%;" | Direct | |||
| style = "width: 50%;" | Indirect | |||
|- | |||
| valign = top | | |||
* Pneumonia | |||
* Aspiration of gastric contents | |||
* Inhalational injury | |||
* Pulmonary contusion | |||
* Pulmonary vasculitis | |||
* Drowning | |||
| valign = top | | |||
* Non-pulmonary sepsis | |||
* Major trauma | |||
* Pancreatitis | |||
* Severe burns | |||
* Non-cardiogenic shock | |||
* Drug overdose | |||
* Multiple transfusions or transfusion-associated acute lung injury (TRALI) | |||
|} | |} | ||
Revision as of 21:59, 12 July 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Brian Shaller, M.D. [2]
Overview
Established by the the European Society of Intensive Care Medicine in 2012, the Berlin definition is the most current set of diagnostic criteria for ARDS.
Diagnostic criteria
The Berlin Definition of Acute Respiratory Distress Syndrome
The diagnosis of ARDS is made when the following criteria are met:[1]
| The Berlin Definition of Acute Respiratory Distress Syndrome | |
|---|---|
| Timing | ❑ Within 1 week of a known clinical insult or new or worsening respiratory symptoms |
| Chest imaging a | ❑ Bilateral opacities – not fully explained by effusions, lobar/lung collapse, or nodules |
| Origin of edema | ❑ Respiratory failure not fully explained by cardiac failure or fluid overload ❑ Need objective assessment (e.g., echocardiography) to exclude hydrostatic edema if no risk factor present |
| Oxygenation b | |
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❑ 200 mm Hg < PaO2/FiO2 ≤ 300 mm Hg with PEEP or CPAP ≥ 5 cm H2O c |
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❑ 100 mm Hg < PaO2/FiO2 ≤ 200 mm Hg with PEEP ≥ 5 cm H2O |
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❑ PaO2/FiO2 ≤ 100 mm Hg with PEEP ≥ 5 cm H2O |
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a Chest radiograph or computed tomography scan. | |
| Common Risk Factors for ARDS | |
|---|---|
| Direct | Indirect |
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References
- ↑ ARDS Definition Task Force. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E; et al. (2012). "Acute respiratory distress syndrome: the Berlin Definition". JAMA. 307 (23): 2526–33. doi:10.1001/jama.2012.5669. PMID 22797452.