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JOURNAL CLUB - A New Global Definition of Acute Respiratory Distress Syndrome - ARDS

By: Marcelo Alcantara, Médico - 05/19/2023 15:25

🤔 Acute Respiratory Distress Syndrome or ARDS can be defined as a condition characterized by the acute installation of respiratory failure resulting from lung parenchyma injury of an inflammatory nature, compromising the alveolar-capillary barrier, determining, among other things, the formation of edema and alveolar collapse. In addition, the histopathological picture may progress to diffuse alveolar damage (DAD).

🤔 Since its original description in 1967, 56 years ago, there have been controversies regarding its definition, taxonomy, and grouping under the ARDS label of different conditions and etiologies that share similarities. 

🧐A consensus document prepared by 32 experts in intensive care and ARDS from various regions of the world will be presented at a Mini-Symposium at the Conference of the American Thoracic Society on May 24th in Washington, DC, USA.

🧐 Their main suggestions for a new definition of ARDS are presented below:

👉 Inclusion of the need for respiratory support with a High Flow Nasal Cannula (HFNC) > 30l/min or the need for CPAP or NIV with PEEP > 5cmH2O for non-intubated patients

  👉 Inclusion of the SpO2/FIO2 ratio<315 with SpO2<97% as an alternative criterion to the PaO2/FIO2 ratio

👉Inclusion of lung US (performed by a trained professional) to assess the presence of bilateral pulmonary infiltrates

Note: in situations with limited access to resources, disregard the need for criteria such as the need for PEEP, high flow, or the use of specific respiratory support devices.

Here's a link to the abstract:

A New Global Definition of Acute Respiratory Distress Syndrome

😎To discuss this expansion of the ARDS definition, we added these elements to a figure that presents the Berlin Definition plus the new suggested criteria

🧐 What are the possible advances or drawbacks of this new proposal for ARDS definition?

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