Acute respiratory distress syndrome diagnostic criteria: Difference between revisions

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| '''Chest imaging''' <sup>'''a'''</sup>
| '''Chest imaging''' <sup>'''a'''</sup>
| ❑ Bilateral opacities – not fully explained by effusions, lobar/lung collapse, or nodule
| ❑ [[Pulmonary consolidation|Bilateral opacities]] – not fully explained by [[Pulmonary Edema|effusions]], lobar/lung collapse, or [[Lung nodule|nodule]]
|-
|-
| '''Origin of edema'''
| '''Origin of edema'''
| ❑ Respiratory failure not fully explained by cardiac failure or fluid overload <sup>'''b'''</sup>
| ❑ [[Respiratory failure]] not fully explained by [[Heart failure|cardiac failure]] or [[Hypervolemia|fluid overload]] <sup>'''b'''</sup>
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| colspan="2" style="text-align: left;" | '''Oxygenation <sup>c</sup>'''
| colspan="2" style="text-align: left;" | '''[[Oxygenation]] <sup>c</sup>'''
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:''Mild''<br>''(27% 90-day mortality rate)''
:''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>
| ❑ 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>'''d'''</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'''</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>'''b'''</sup> ''Need objective assessment (e.g., [[Echocardiogram|echocardiography]]) to exclude [[Pulmonary Edema|hydrostatic edema]] if no [[Acute respiratory distress syndrome causes|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>'''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>
:<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>
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Revision as of 05:14, 30 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
Mild
(27% 90-day mortality rate)
❑ 200 mm Hg < PaO2/FIO2 ≤ 300 mmHg with PEEP or CPAP > 5 cm H2O d
Moderate
(32% 90-day mortality rate)
❑ 100 mm Hg < PaO2/FIO2 ≤ 200 mm Hg with PEEP ≥ 5 cm H2O
Severe
(45% 90-day mortality rate)
❑ PaO2/FiO2 ≤ 100 mm Hg with PEEP ≥ 5 cm H2O
a X-ray or CT scan of the chest
b Need objective assessment (e.g., echocardiography) to exclude hydrostatic edema if no risk factor present
c If altitude is higher than 1000 m, the correction factor should be calculated as follows: PaO2/FIO2 x (barometric pressure/760)
d Positive pressure may be delivered noninvasively in the mild ARDS group

References

  1. 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.

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