Acute respiratory distress syndrome diagnostic criteria: Difference between revisions
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! colspan="2" style="text-align: center;" | '''Acute Respiratory Distress Syndrome | ! colspan="2" style="text-align: center;" | '''The Berlin Definition of Acute Respiratory Distress Syndrome''' | ||
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| '''Timing''' | | '''Timing''' | ||
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| '''Chest imaging''' <sup>'''a'''</sup> | | '''Chest imaging''' <sup>'''a'''</sup> | ||
| ❑ [[Pulmonary consolidation|Bilateral opacities]] – not fully explained by [[Pulmonary Edema|effusions]], lobar/lung collapse, or [[Lung nodule| | | ❑ [[Pulmonary consolidation|Bilateral opacities]] – not fully explained by [[Pulmonary Edema|effusions]], lobar/lung collapse, or [[Lung nodule|nodules]] | ||
|- | |- | ||
| '''Origin of edema''' | | '''Origin of edema''' | ||
| ❑ [[Respiratory failure]] not fully explained by [[Heart failure|cardiac failure]] or [[Hypervolemia|fluid overload]] < | | ❑ [[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 [[Acute respiratory distress syndrome risk factors|risk factor]] present | ||
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| colspan="2" style="text-align: left;" | '''[[Oxygenation]] <sup> | | colspan="2" style="text-align: left;" | '''[[Oxygenation]] <sup>b</sup>''' | ||
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| | | | ||
:''Mild''<br>''(27% 90-day mortality rate)'' | :''Mild''<br>''(27% 90-day mortality rate)'' | ||
| ❑ 200 mm Hg < [[PaO2|PaO<sub>2</sub>]]/[[FiO2|FIO<sub>2</sub>]] ≤ 300 mmHg with [[PEEP]] or [[CPAP]] > 5 cm H<sub>2</sub>O <sup>''' | | ❑ 200 mm Hg < [[PaO2|PaO<sub>2</sub>]]/[[FiO2|FIO<sub>2</sub>]] ≤ 300 mmHg with [[PEEP]] or [[CPAP]] > 5 cm H<sub>2</sub>O <sup>'''c'''</sup> | ||
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! colspan="2" style="text-align: left;" | | ! 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>'''a'''</sup> ''[[X-ray]] or [[CT scan]] of the chest''</span><br> | ||
:<span style="font-size:85%; line-height: 0.0em;"><sup>'''b | :<span style="font-size:85%; line-height: 0.0em;"><sup>'''b'''</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>'''c'''</sup> ''[[Positive pressure ventilation|Positive pressure]] may be delivered [[Positive airway pressure|noninvasively]] in the mild ARDS group''</span><br> | |||
:<span style="font-size:85%; line-height: 0.0em;"><sup>''' | |||
|} | |} | ||
Revision as of 21:27, 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 diagnosis of ARDS is made when the following diagnostic 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 mmHg 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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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.