TABLE 1.
Acute Respiratory Distress Syndrome Definitions and Their Criteria
Berlin Criteria | Kigali Modification | New Global Definition of ARDS | |
---|---|---|---|
Timing | Within 1 wk of a known clinical insult or new or worsening respiratory symptoms | Within 1 wk of a known clinical insult or new or worsening respiratory symptoms | Within 1 wk of a known clinical insult or new or worsening respiratory symptoms |
Oxygenation | Pao2/Fio2 ≤ 300 mm Hg | Spo2/Fio2 ≤ 315 mm Hg with Spo2 < 97% as hypo-oxygenation | Pao2/Fio2 ≤ 300 mm Hg or Spo2/Fio2 ≤ 315 mm Hg with Spo2 < 97% as hypo-oxygenation when Pao2/Fio2 is unavailable |
PEEP requirement | Minimum 5 cm H2O PEEP with invasive or noninvasive in mild ARDS | No PEEP requirement | Minimum 5cm H2O PEEP with invasive or noninvasive in mild ARDS or ≥ 30L high flow nasal oxygen PEEP requirements can be left out in resource poor settings |
Chest imaging | Bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules by chest radiography or CT | Bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules by chest radiography, CT, or lung ultrasound | Bilateral pulmonary abnormalities not fully explained by effusions, lobar/lung collapse, or nodules by chest radiography, CT, or lung ultrasound |
Origin of edema | Respiratory failure not fully explained by cardiac failure or fluid overload | Respiratory failure not fully explained by cardiac failure or fluid overload | Respiratory failure not fully explained by cardiac failure or fluid overload |
ARDS = acute respiratory distress syndrome, PEEP = positive end expiratory pressure.