ARDS Berlin criteria
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ARDS Berlin definition criteria 2012 official
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acute respiratory distress syndrome Berlin definition
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ARDS Berlin Criteria (2012)
ARDS is diagnosed when all four are present:
| Criterion | Requirement |
|---|---|
| Timing | Onset within 1 week of a known clinical insult, or new/worsening respiratory symptoms |
| Chest imaging | Bilateral opacities on chest radiograph or CT, not fully explained by effusions, lobar/lung collapse, or nodules |
| Origin of pulmonary edema | Respiratory failure not fully explained by cardiac failure or fluid overload. If no ARDS risk factor is apparent, objectively assess, such as with echocardiography, to exclude hydrostatic edema |
| Oxygenation | PaO₂/FiO₂ ≤300 mmHg, with PEEP or CPAP ≥5 cm H₂O |
Severity classification
| Severity | PaO₂/FiO₂ ratio | PEEP/CPAP |
|---|---|---|
| Mild ARDS | >200 to ≤300 mmHg | ≥5 cm H₂O |
| Moderate ARDS | >100 to ≤200 mmHg | ≥5 cm H₂O |
| Severe ARDS | ≤100 mmHg | ≥5 cm H₂O |
Memory aid: “Timing - X-ray - Edema - Oxygenation.”
The definition removed the old term acute lung injury (ALI). It also requires a minimum positive-pressure support level to standardize oxygenation assessment. The original Berlin definition publication and a textbook table in Tintinalli's Emergency Medicine state these criteria.
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