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The American-European Consensus Conference definition of the acute respiratory distress syndrome is dead, long live positive end-expiratory pressure!

Abstract：

:In 1994, an American-European Consensus Conference (AECC) formalized the criteria for the diagnosis of the acute respiratory distress syndrome (ARDS). Although that definition is simple to apply in the clinical setting, it has been challenged over the years in several studies since the assessment of the oxygenation defect does not require standardized ventilatory support. We were the first to propose new guidelines, based on a specific, standard method of evaluating oxygenation status, a proposal that was later advocated by others. To address the limitations of the AECC definition, a modified ARDS definition has been proposed by a task force panel of experts, referred to as the Berlin Defintion, using a terminology similar to that we previously proposed. However, that proposal has several methodological flaws. Since all ARDS patients start off with terrible oxygenation, the Berlin Definition offers no room for stratifying and identifyng true ARDS patients since there is no further re-evaluation of the hypoxemia under standard ventilator setting in a specific time period. In this Point of View, we review the history of the definition of ARDS and discussed the methodological concerns regarding adopting this new, revised ARDS definition.

journal_name

Med Intensiva

journal_title

Medicina intensiva

authors

Villar J,Kacmarek RM

doi

10.1016/j.medin.2012.08.010

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

571-5

issue

8

eissn

0210-5691

issn

1578-6749

pii

S0210-5691(12)00269-0

journal_volume

36

pub_type

共识发展会议,杂志文章

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