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Critical Care
Published in: Critical Care 4/2013

01-08-2013 | Editorial

The Berlin definition: real change or the emperor's new clothes?

Author: Charles R Phillips

Published in: Critical Care | Issue 4/2013

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Excerpt

The Berlin consensus group met recently after 18 years of defining acute respiratory distress syndrome (ARDS) using the American European Consensus Committee (AECC) criteria because, in their words, 'a number of issues regarding various criteria of the AECC definition have emerged, including a lack of explicit criteria for defining acute, sensitivity of PaO2/FiO2 to different ventilator settings, poor reliability of the chest radiograph (CXR) criterion, and difficulties distinguishing hydrostatic edema' [1]. Save for defining acute, they arrived at a new definition using nearly these exact same criteria and thus did not answer their original concerns. …
Literature
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ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota L, Slutsky AS: Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012, 307: 2526-2533.
2.
Thompson BT, Matthay MA: The Berlin definition of ARDS versus pathological evidence of diffuse alveolar damage. Am J Respir Crit Care Med. 2013, 187: 675-677. 10.1164/rccm.201302-0385ED.PubMedCrossRef
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Furian T, Aguiar C, Prado K, Ribeiro RV, Becker L, Martinelli N, Clausell N, Rohde LE, Biolo A: Ventricular dysfunction and dilation in severe sepsis and septic shock: relation to endothelial function and mortality. J Crit Care. 2012, 27: 319.e9-e15. 10.1016/j.jcrc.2011.06.017.CrossRef
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Monnet X, Anguel N, Osman D, Hamzaoui O, Richard C, Teboul JL: Assessing pulmonary permeability by transpulmonary thermodilution allows differentiation of hydrostatic pulmonary edema from ALI/ARDS. Intensive Care Med. 2007, 33: 448-453. 10.1007/s00134-006-0498-6.PubMedCrossRef
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Kushimoto S, Taira Y, Kitazawa Y, Okuchi K, Sakamoto T, Ishikura H, Endo T, Yamanouchi S, Tagami T, Yamaguchi J, Yoshikawa K, Sugita M, Kase Y, Kanemura T, Takahashi H, Kuroki Y, Izumino H, Rinka H, Seo R, Takatori M, Kaneko T, Nakamura T, Irahara T, Saito N, Watanabe A, PiCCO Pulmonary Edema Study Group: The clinical usefulness of extravascular lung water and pulmonary vascular permeability index to diagnose and characterize pulmonary edema: a prospective multicenter study on the quantitative differential diagnostic definition for acute lung injury/acute respiratory distress syndrome. Crit Care. 2012, 16: R232-10.1186/cc11898.PubMedPubMedCentralCrossRef
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Jozwiak M, Silva S, Persichini R, Anguel N, Osman D, Richard C, Teboul JL, Monnet X: Extravascular lung water is an independent prognostic factor in patients with acute respiratory distress syndrome. Crit Care Med. 2013, 41: 472-480. 10.1097/CCM.0b013e31826ab377.PubMedCrossRef
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Britos M, Smoot E, Liu KD, Thompson BT, Checkley W, Brower RG, National Institutes of Health Acute Respiratory Distress Syndrome Network Investigators: The value of positive end-expiratory pressure and FiO2 criteria in the definition of the acute respiratory distress syndrome. Crit Care Med. 2011, 39: 2025-2030. 10.1097/CCM.0b013e31821cb774.PubMedPubMedCentralCrossRef
Metadata
Title
The Berlin definition: real change or the emperor's new clothes?
Author
Charles R Phillips
Publication date
01-08-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc12761

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