The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material

@article{Ferguson2012TheBD,
  title={The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material},
  author={Niall D. Ferguson and Eddy Fan and Luigi Camporota and Massimo Antonelli and Antonio Anzueto and Richard Beale and Laurent J. Brochard and Roy G. Brower and Andr{\'e}s Esteban and Luciano Gattinoni and Andrew Rhodes and Arthur S Slutsky and Jean Louis Vincent and Gordon David Rubenfeld and Boyd Taylor Thompson and Vito Marco Ranieri},
  journal={Intensive Care Medicine},
  year={2012},
  volume={38},
  pages={1573-1582}
}
PurposeOur objective was to revise the definition of acute respiratory distress syndrome (ARDS) using a conceptual model incorporating reliability and validity, and a novel iterative approach with formal evaluation of the definition. [] Key MethodMethodsThe European Society of Intensive Care Medicine identified three chairs with broad expertise in ARDS who selected the participants and created the agenda.
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967 Citations
Highly Influential Citations
55
Background Citations
269
Methods Citations
168
Results Citations
10

967 Citations

Citation Type

Citation Type

ARDS: Are the current definitions useful?
The Berlin definition met our needs: yes
TLDR
Like other syndromic illnesses such as depression or sepsis, a challenge in defining ARDS is the lack of a reference gold standard for its diagnosis, and the definition has evolved over time with progressive refinements.
The Berlin definition met our needs: no
TLDR
Like other syndromic illnesses such as depression or sepsis, a challenge in defining ARDS is the lack of a reference gold standard for its diagnosis, and the definition has evolved over time with progressive refinements.
New Definition of Acute Respiratory Distress Syndrome
TLDR
An international expert panel to revise the ARDS definition from September 30 to October 2, 2011, Berlin, Germany, addressed some of the limitations of the AECC definition by incorporating current data, physiologic concepts, and clinical trials to develop a new definition of ARDS (Berlin definition).
The Kigali modification of the berlin definition: a new epidemiological tool for ARDS?
TLDR
The study interestingly points at a limitation of the Berlin definition, that is the real difficulties in a correct estimation of ARDS incidence in developing countries, taking into accounts differences in resource availability and especially in capacity for positive pressure ventilation and ICU beds.
The ten diseases that look like ARDS
TLDR
Ten clinical entities that may be mistaken for ARDS are discussed, including lung biopsy findings in patients with what is assumed to be unresolving ARDS frequently show a number of pathologic entities other than DAD.
Pediatric Acute Respiratory Distress Syndrome: Definition and Epidemiology
TLDR
In 2015, the Pediatric Acute Lung Injury Consensus Conference (PALICC) published specific definitions for pediatric ARDS and those gauged to be at risk for PARDS, as well as recommendations regarding management and suggested priorities for future research.
Lung ultrasound and neonatal ARDS: is Montreux closer to Berlin than to Kigali?
The use of the Berlin definition for acute respiratory distress syndrome during infancy and early childhood: multicenter evaluation and expert consensus
TLDR
BD validity for children is similar to that already reported in adults and mainly due to the introduction of a “severe ARDS” category.
Interobserver Reliability of the Berlin ARDS Definition and Strategies to Improve the Reliability of ARDS Diagnosis
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References

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TLDR
The radiographic criterion used in the current AECC definition for ALI-ARDS showed high interobserver variability when applied by expert investigators in the fields of mechanical ventilation and ARDS.
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TLDR
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The acute respiratory distress syndrome (ARDS), a process of nonhydrostatic pulmonary edema and hypoxemia associated with a variety of etiologies, carries a high morbidity, mortality (10 to 90%), and…
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The differences in the respiratory severity index during the first 24 h of inclusion, PaO2/FIO2 ratio at baseline and at 24 h, maximum plateau airway pressure, maximum level of PEEP, and number of organ system failures during the ICU stay were statistically significant.
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TLDR
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TLDR
The American-European Consensus Committee on ARDS was formed to re-evaluate the standards for the ICU care of patients with acute lung injury (ALI), with regard to ventilatory strategies, the more promising pharmacologic agents, and the definition and quantification of pathologic features of ALI that require resolution.
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TLDR
The criterion validity of the definition of ARDS proposed by the AmericanEuropean Consensus Conference was evaluated by using autopsy findings as the reference standard and whether the validity of this definition was modified according to the presence of pulmonary or extrapulmonary risk factors.
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TLDR
The use of standardized ventilator settings to screen and enroll ARDS patients in a clinical trial of high-frequency oscillatory ventilation (HFOV) significantly impacted the PaO2/FIO2 ratio and therefore the ARDS prevalence and trial enrollment.
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