Berlin Criteria for Acute Respiratory Distress Syndrome
Provides diagnostic criteria for acute respiratory distress syndrome (ARDS).
Advice
- Always interpret results in the context of clinical evaluation and expert input.
- Reassess ARDS severity throughout the patient’s clinical course as oxygenation and ventilatory needs evolve.
Management
- For patients who do not meet criteria for ARDS:
- Evaluate alternative diagnoses and contributing conditions.
- Reassess if new data become available or if the patient’s clinical status changes.
- For patients who meet criteria for ARDS:
- Initiate lung-protective ventilation: tidal volume 4–8 mL/kg predicted body weight (PBW), plateau pressure <30 cm H₂O, minimize driving pressure.
- Consider a high-PEEP strategy, especially in moderate-to-severe cases.
- Use prone positioning in moderate-to-severe ARDS.
- If hemodynamically stable, adopt a conservative fluid management approach.
- For refractory hypoxemia, consider ECMO in experienced centers; tools that may support further assessment include: