The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material

Ferguson, Niall D.; Fan, Eddy; Camporota, Luigi; Antonelli, Massimo; Anzueto, Antonio; Beale, Richard; Brochard, Laurent; Brower, Roy G.; Esteban, Andrés; Gattinoni, Luciano; Rhodes, Andrew; Slutsky, Arthur S.; Vincent, Jean‐Louis; Rubenfeld, Gordon D.; Thompson, B. Taylor; Ranieri, V. Marco

doi:10.1007/s00134-012-2682-1

Cited by 1,133 publications

(938 citation statements)

References 43 publications

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“…ARDS was defined according to the criteria stated by the American-European Consensus Conference (AECC) on ARDS [14]: i.e., the diagnosis required an acute onset of symptoms, the presence of bilateral infiltrates on chest radiography, a pulmonaryartery wedge pressure below 18 mmHg and/or the absence of signs of left ventricular dysfunction, and a partial pressure of oxygen in arterial blood to fraction of inspired oxygen ratio (P/F) no greater than 200. Patients that met the above criteria but with a P/F ratio of 300 or below, classified as ALI according to AECC criteria, were also included in the analysis because the updated definition of ARDS according to the Berlin definition [15,16] classifies this category as mild ARDS. Henceforth in this article patients with ALI according to AECC criteria will be categorized as mild ARDS.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

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Plasma suPAR as a prognostic biological marker for ICU mortality in ARDS patients

et al. 2015

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Purpose: We investigated the prognostic value of plasma soluble urokinase plasminogen activator receptor (suPAR) on day 1 in patients with the acute respiratory distress syndrome (ARDS) for intensive care unit (ICU) mortality and compared it with established disease severity scores on day 1. Methods: suPAR was determined batchwise in plasma obtained within 24 h after admission. Results: 632 ARDS patients were included. Significantly (P = 0.02) higher median levels of suPAR were found with increasing severity of ARDS: 5.9 ng/ml [IQR 3.1-12.8] in mild ARDS (n = 82), 8.4 ng/ml .0] in moderate ARDS (n = 333), and 9.0 ng/ml .0] in severe ARDS (n = 217). Non-survivors had higher median levels of suPAR [12.5 ng/ml (IQR 5.1-19.5) vs. 7.4 ng/ml (3.9-13.6), P \ 0.001]. The area under the receiver operator characteristic curve (ROC-AUC) for mortality of suPAR (0.62) was lower than the ROC-AUC of the APACHE IV score (0.72, P = 0.007), higher than that of the ARDS definition classification (0.53, P = 0.005), and did not differ from that of the SOFA score (0.68, P = 0.07) and the oxygenation index (OI) (0.58, P = 0.29). Plasma suPAR did not improve the discrimination of the established disease severity scores, but did improve net reclassification of the APACHE score (29 %), SOFA score (23 %), OI (38 %), and Berlin definition classification (39 %). Conclusion: As a single biological marker, the prognostic value for death of plasma suPAR in ARDS patients is low. Plasma suPAR, however, improves the net reclassification, suggesting a potential role for suPAR in ICU mortality prediction models.

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Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

“…The Acute Physiology and Chronic Health Evaluation (APACHE) IV score [17], the Sequential Organ Failure Assessment (SOFA) [18] score, the Oxygenation Index (OI) [19], and the Berlin classification [15,16] were determined in the first 24 h after admission.…”

Section: Established Disease Severity Scoring Systemsmentioning

confidence: 99%

Plasma suPAR as a prognostic biological marker for ICU mortality in ARDS patients

et al. 2015

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“…Since the establishment of the new definition of ARDS in 2012, the concept of initiating therapeutic interventions according to disease severity was introduced,35, 185 and numerous reports have been made in recent years describing the clinical utility of techniques such as oxygen therapy in mild ARDS cases, oxygen therapy administered via high‐flow nasal cannula (high‐flow nasal therapy), and noninvasive positive pressure ventilation 186, 187, 188, 189. Administering oxygen in some form to sepsis patients presenting with hypoxemia is widely practiced, and while this approach is believed to help prevent the onset of acute respiratory failure leading to ARDS, there is currently no clear supporting evidence.…”

Section: Introductionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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“…Fourth, the term acute lung injury was abandoned. Fifth, measurement of the PaO 2 /FIO 2 ratio was changed to require a specific minimum amount of PEEP; three categories of ARDS were proposed (mild, moderate, and severe) based on the PaO 2 /FIO 2 ratio cutoffs of 300 and below [17,18]. In addition, minute ventilation (as a surrogate for dead space), and compliance of the respiratory system were initially proposed by the consensus panel.…”

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confidence: 99%

Defining ARDS: do we need a mandatory waiting period?

Rubenfeld

Thompson

2013

Intensive Care Med

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The Berlin definition of ARDS: an expanded rationale, justification, and supplementary material

Cited by 1,133 publications

References 43 publications

Plasma suPAR as a prognostic biological marker for ICU mortality in ARDS patients

Plasma suPAR as a prognostic biological marker for ICU mortality in ARDS patients

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016)

Defining ARDS: do we need a mandatory waiting period?

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