Sept. 5, 2023 – In a new report posted online in the American Journal of Respiratory and Critical Care Medicine , a global consensus conference of 32 critical care experts with broad international representation and from diverse backgrounds has proposed a new definition of acute respiratory distress syndrome (ARDS) . In addition to the experts, critical care societies from around the world provided input, once they received feedback from their members. The report, which builds on the 2012 Berlin Definition of ARDS, will be published Jan. 1, 2024 in the American Thoracic Society’s AJRCCM.
ARDS is a life-threatening illness in which the lungs are severely inflamed. It has a number of possible causes, including sepsis and severe pneumonia.
Leaders in the field saw the need for an expanded definition due to new research and developments in the diagnosis and treatment of ARDS such as:
“One of the major limitations of the Berlin Definition is that its requirement for invasive or non-invasive ventilation cannot be met in settings where mechanical ventilation is not available,” said corresponding author Michael A. Matthay, MD, professor, medicine and anesthesia; associate director, critical care medicine; and senior associate, Cardiovascular Research Institute, University of California, San Francisco. “By expanding the definition of ARDS and the use of pulse oximetry and ultrasound to help diagnose and stage ARDS, and HFNO to treat it, we will be able to help many more patients who are in resource-limited settings. This expanded definition also opens up new avenues of research and will encourage clinical trials to test new treatments that can include more ARDS patients who were not previously included because they were not mechanically ventilated.”
As described in the article, the committee made minor modifications to the Berlin Definition’s conceptual model of ARDS and proposed four main recommendations :
“The new definition will likely enhance recognition of ARDS in many patients at an earlier stage of their respiratory failure, when interventions are more likely to succeed,” said Dr. Matthay.
American Journal of Respiratory and Critical Care Medicine
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