Acute respiratory distress syndrome diagnostic criteria: Difference between revisions
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| ❑ Within 1 week of a known clinical insult or new or worsening respiratory symptoms | | ❑ Within 1 week of a known clinical insult or new or worsening respiratory symptoms | ||
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| '''Chest imaging''' <sup> | | '''Chest imaging''' <sup>a</sup> | ||
| ❑ [[Pulmonary consolidation|Bilateral opacities]] – not fully explained by [[Pulmonary Edema|effusions]], lobar/lung collapse, or [[Lung nodule|nodules]] | | ❑ [[Pulmonary consolidation|Bilateral opacities]] – not fully explained by [[Pulmonary Edema|effusions]], lobar/lung collapse, or [[Lung nodule|nodules]] | ||
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| ❑ [[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 diagnostic criteria#Common Risk Factors for ARDS|risk factor]] present | | ❑ [[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 diagnostic criteria#Common Risk Factors for ARDS|risk factor]] present | ||
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| colspan="2" style="text-align: left;" | '''[[Oxygenation]] <sup>b</sup> | | colspan="2" style="text-align: left;" | '''[[Oxygenation]]''' <sup>b</sup> | ||
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| | | | ||
: | :Mild | ||
| ❑ 200 mm Hg < [[PaO2|PaO<sub>2</sub>]]/[[FiO2| | | ❑ 200 mm Hg < [[PaO2|PaO<sub>2</sub>]]/[[FiO2|FiO<sub>2</sub>]] ≤ 300 mm Hg with [[PEEP]] or [[CPAP]] ≥ 5 cm H<sub>2</sub>O <sup>c</sup> | ||
|- | |- | ||
| | | | ||
: | :Moderate | ||
| ❑ 100 mm Hg < PaO<sub>2</sub>/ | | ❑ 100 mm Hg < [[PaO2|PaO<sub>2</sub>]]/[[FiO2|FiO<sub>2</sub>]] ≤ 200 mm Hg with [[PEEP]] ≥ 5 cm H<sub>2</sub>O | ||
|- | |- | ||
| | | | ||
: | :Severe | ||
| ❑ PaO<sub>2</sub>/FiO<sub>2</sub> ≤ 100 mm Hg with PEEP ≥ 5 cm H<sub>2</sub>O | | ❑ [[PaO2|PaO<sub>2</sub>]]/[[FiO2|FiO<sub>2</sub>]] ≤ 100 mm Hg with [[PEEP]] ≥ 5 cm H<sub>2</sub>O | ||
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| colspan="2" | | |||
<span style="font-size: 85%;"><sup>a</sup> [[Chest radiograph]] or [[computed tomography]] scan.</span><br> | |||
<span style="font-size: 85%;"><sup>b</sup> If [[altitude]] is higher than 1000 m, the correction factor should be calculated as follows: <nowiki>[</nowiki>PaO<sub>2</sub>/FIO<sub>2</sub> × ([[barometric pressure]]/760)<nowiki>]</nowiki>.</span><br> | |||
<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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Revision as of 21:44, 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. | |
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.