The Global Definition of Acute Respiratory Distress Syndrome
Welcome to the home of the new Global Definition of ARDS. This site and its content are being developed as a place for dissemination and comment.
Why is a new definition needed?
In the decade since the Berlin Definition of ARDS was published, several issues have emerged that prompt consideration of an expansion of the criteria. As a result, patients with ARDS are now managed in ways that may not meet the Berlin Definition’s strict reliance on invasive mechanical ventilation and chest radiographs for diagnosis. A revised definition is required to allow for more inclusive diagnostic criteria relevant to current global practice.
How has the new definition been designed?
A Consensus Conference of 32 critical care ARDS experts was convened and subsequently obtained input from members of several critical care societies. A detailed description of the methodology can be viewed here
The goal was to develop a definition that would:
identify patients with the currently accepted conceptual framework for ARDS.
facilitate rapid ARDS diagnosis for clinical care and research.
be applicable in resource-limited settings.
be useful for testing specific therapies.
be practical for communication to patients and caregivers.
How does the new definition differ?
The Global Definition offers some key changes to address the goals set out above. The full detail of the definition can be viewed here.
| Global definition | Berlin definition | |
|---|---|---|
| Timing | No change | Within 1 week of a known clinical insult or new or worsening respiratory symptoms |
| Chest imaging | Addition of bilateral B lines and/or consolidation by ultrasound | Chest radiograph and/or computed tomography only |
| Oxygenation | SpO2/FiO2 can be used for diagnosis and assessment of severity if SpO2 is ≤97% | PaO2/FiO2 ratio only |
| New category of non-intubated ARDS created for patients on HFNO at ≥30 L/min or NIV/CPAP, who otherwise meet ARDS criteria | Mechanical ventilation or CPAP required | |
| Modified definition of ARDS for resource-variable settings does not require PaO2/FiO2, PEEP, or HFNO | No provision |