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EXPLORING THE BERLIN DEFINITION OF ARDS
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The ARDS Definition Task Force, Acute Respiratory Distress Syndrome. The Berlin Definition, Published online May 21 2012. An initiative of, Endorsed by, Available at www jama com. Copyright restrictions apply jamanetwork com, Why Do We Need an. ARDS Defintion AT ALL, Reliable and Valid Definitions are.
ESSENTIAL to Conduct and, Interpret Clinical Research. Importance to Researchers, Enable epidemiological studies. Facilitate enrolment into clinical trials, Allow comparison between studies. Enhance linkages between clinical and basic science. Phenotype Genotype relationship, Importance to Clinicians. Ability to implement results of positive RCTs in clinical. Lower Vt for ALI, May also be useful in prognostic discussions with.
patients families, Importance to Administrators, Epidemiological studies need definitions. These in turn may be useful in planning resource allocation. The American European Consensus, Conference on ARDS. Bernard et al AJRCCM 1994 149 818 24, American European Consensus AECC. PaO2 FIO2 200, Acute onset, CXR with bilateral infiltrates. Regardless of PEEP level, or no clinical evidence of left atrial hypertension.
Sensibility Concerns AECC, No definition of acute, Risk factors not included. Inconsistency of PaO2 FIO2 ratio, Effect of PEEP, Effect of FIO2. PCWP ARDS can coexist, Interpretation of the CXR has poor reliability. Crit Care Med 2008 36 2912 2921, Effects of Airway Pressure. PAW 22 PaO2 FIO2 80 PAW 30 PaO2 FIO2 281, AECC Sensibility Concerns.
No definition of acute, Appropriate clinical setting not formally. Inconsistency of PaO2 FIO2 ratio, effect of PEEP, effect of FIO2. PCWP and ARDS can coexist, CXR interpretation has poor reliability. 15 15 18 19 22 23 26 26, Median PAWP mm Hg, Data from Stewart et al NEJM 1998 338 335 61. 29 had PAOP 18, 97 of these had N or, elevated CI, Interobserver variability in.
applying a radiographic, definition of ARDS, Rubenfeld et al Chest 1999 116 1347 53. Interobservervariability in applying a radiographic definition of ARDS Rubenfeldet al Chest1999 116 1347 53 21 clinical researchers and opinion leaders 28 CXRs from hypoxemic ICU patients 0 55 0 02 for inter observer agreement 13 28 CXRs showed near perfect agreement Interobserver variation in interpreting chest

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