Acute respiratory distress syndrome diagnostic criteria: Difference between revisions
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{{Acute respiratory distress syndrome}} | {{Acute respiratory distress syndrome}} | ||
{{CMG}} {{AE}} | {{CMG}}, {{AE}} {{BShaller}} | ||
==Overview== | ==Overview== | ||
Established by the [[Acute respiratory distress syndrome historical perspective|ARDS Definition Task Force]] in 2012, the '''Berlin Definition''' is the most current set of diagnostic criteria for ARDS. | |||
==Diagnostic criteria== | ==Diagnostic criteria== | ||
The diagnosis of ARDS is made when the following diagnostic 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> | |||
{| class="wikitable" | |||
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! colspan="2" style="text-align: center;" | '''Acute Respiratory Distress Syndrome – The Berlin Definition (2012)''' | |||
|- | |||
| '''Timing''' | |||
| ❑ Within 1 week of a known clinical insult or new or worsening respiratory symptoms | |||
|- | |||
| '''Chest imaging''' <sup>'''a'''</sup> | |||
| ❑ Bilateral opacities – not fully explained by effusions, lobar/lung collapse, or nodule | |||
|- | |||
| '''Origin of edema''' | |||
| ❑ Respiratory failure not fully explained by cardiac failure or fluid overload <sup>'''b'''</sup> | |||
|- | |||
| colspan="2" style="text-align: left;" | '''Oxygenation <sup>c</sup>''' | |||
|- | |||
| | |||
:''Mild''<br>''(27% 90-day mortality rate)'' | |||
| ❑ 200 mm Hg < PaO<sub>2</sub>/FiO<sub>2</sub> ≤ 300 mmHg with PEEP or CPAP > 5 cm H<sub>2</sub>O <sup>'''d'''</sup> | |||
|- | |||
| | |||
:''Moderate''<br>''(32% 90-day mortality rate)'' | |||
| ❑ 100 mm Hg < PaO<sub>2</sub>/FIO<sub>2</sub> ≤ 200 mm Hg with PEEP ≥ 5 cm H<sub>2</sub>O | |||
|- | |||
| | |||
:''Severe''<br>''(45% 90-day mortality rate)'' | |||
| ❑ PaO<sub>2</sub>/FiO<sub>2</sub> ≤ 100 mm Hg with PEEP ≥ 5 cm H<sub>2</sub>O | |||
|- | |||
! colspan="2" style="text-align: left;" | | |||
:<span style="font-size:85%; line-height: 0.0em;"><sup>'''a'''</sup> ''[[X-ray]] or [[CT scan]] of the chest''</span><br> | |||
:<span style="font-size:85%; line-height: 0.0em;"><sup>'''b'''</sup> ''Need objective assessment (e.g., [echocardiography]]) to exclude [[Edema|hydrostatic edema]] if no risk factor present''</span><br> | |||
:<span style="font-size:85%; line-height: 0.0em;"><sup>'''c'''</sup> ''If altitude is higher than 1000 m, the correction factor should be calculated as follows: PaO<sub>2</sub>/FIO<sub>2</sub> x (barometric pressure/760)''</span> | |||
:<span style="font-size:85%; line-height: 0.0em;"><sup>'''d'''</sup> ''[[Positive pressure ventilation|Positive pressure]] may be delivered [[Positive airway pressure|noninvasively]] in the mild ARDS group''</span><br> | |||
|} | |||
==References== | ==References== | ||
Revision as of 12:03, 25 June 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 ARDS Definition Task Force in 2012, the Berlin Definition is the most current set of diagnostic criteria for ARDS.
Diagnostic criteria
The diagnosis of ARDS is made when the following diagnostic criteria are met:[1]
| Acute Respiratory Distress Syndrome – The Berlin Definition (2012) | |
|---|---|
| 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 nodule |
| Origin of edema | ❑ Respiratory failure not fully explained by cardiac failure or fluid overload b |
| Oxygenation c | |
|
❑ 200 mm Hg < PaO2/FiO2 ≤ 300 mmHg with PEEP or CPAP > 5 cm H2O d |
|
❑ 100 mm Hg < PaO2/FIO2 ≤ 200 mm Hg with PEEP ≥ 5 cm H2O |
|
❑ PaO2/FiO2 ≤ 100 mm Hg with PEEP ≥ 5 cm H2O |
| |
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.