Berlin modification of the American European Consensus Committee (AECC) definitions[1]

In 2012, minor modifications to the AECC definitions of ARDS (termed the "Berlin Definition") were made. A diagnosis of ARDS can be made if the patient fulfills all of the following criteria:

  • Acute onset (within 1 week of known clinical insult)

  • Bilateral opacities on chest x-ray (not explained by effusions, collapse, or nodules)

  • Respiratory failure not fully explained by heart failure or fluid overload (objective assessment such as echocardiogram recommended if no risk factor).

Severity of ARDS

  • Mild: PaO₂/FiO₂ 200-300 with positive end-expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) ≥5 cm H₂O

  • Moderate: PaO₂/FiO₂ 100-200 with PEEP ≥5 cm H₂O

  • Severe: PaO₂/FiO₂ ≤100 with PEEP ≥5 cm H₂O.

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