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01-05-2016 | Editorial

The Berlin definition met our needs: not sure

Author: Jean-Louis Vincent

Published in: Intensive Care Medicine | Issue 5/2016

Excerpt

I was fortunate to be one of the participants involved in elaborating the new criteria for the acute respiratory distress syndrome (ARDS) in Berlin in 2012 [1]. I appreciated the discussions during this process and support the outcome. At the same time, I respectfully wonder whether this intellectual performance really helps our patients. Developing new definitions may appear to bring some uniformity to the patient populations included in clinical trials, but it does not eliminate the underlying heterogeneity; it may, therefore, actually contribute to generate additional negative trials. So are these new ARDS definitions really a major advance? …

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Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van HF, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Pesenti A (2016) Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 315:788–800CrossRefPubMed

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Vincent JL, Santacruz C (2015) Traitement de l’ARDS: Ce qui est basé sur l’évidence. Communications Scientifiques 2015. MAPAR Editions, Le Kremlin Bicêtre, pp 177–180

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Kao KC, Hu HC, Chang CH, Hung CY, Chiu LC, Li SH, Lin SW, Chuang LP, Wang CW, Li LF, Chen NH, Yang CT, Huang CC, Tsai YH (2015) Diffuse alveolar damage associated mortality in selected acute respiratory distress syndrome patients with open lung biopsy. Crit Care 19:228CrossRefPubMedPubMedCentral

10.

Guerin C, Bayle F, Leray V, Debord S, Stoian A, Yonis H, Roudaut JB, Bourdin G, Devouassoux-Shisheboran M, Bucher E, Ayzac L, Lantuejoul S, Philipponnet C, Kemeny JL, Souweine B, Richard JC (2015) Open lung biopsy in nonresolving ARDS frequently identifies diffuse alveolar damage regardless of the severity stage and may have implications for patient management. Intensive Care Med 41:222–230. doi:10.1007/s00134-014-3583-2 CrossRefPubMed

11.

Vincent JL, Mira JP, Antonelli M (2016) Sepsis: older and newer concepts. Lancet Respir Med 4:237–240CrossRefPubMed

12.

Vincent JL (2016) Individual gene expression and personalised medicine in sepsis. Lancet Respir Med. doi:10.1016/S2213-2600(16)00068-0

Title: The Berlin definition met our needs: not sure
Author: Jean-Louis Vincent
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 5/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4319-2

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