PARDS

Age

• Berlin Definition: Adults and children
• PARDS: Excludes patients with perinatal-related lung disease

Timing

• Berlin Definition: Within 1 wk of known clinical insult or new or worsening respiratory symptoms
• PARDS: Within 1 wk of a known clinical insult

Origin of edema

• Berlin Definition: Respiratory failure not fully explained by cardiac failure or fluid overload. Need objective assessment (e.g., echocardiography) to exclude hydrostatic edema, even if no risk factor present
• PARDS: Respiratory failure not fully explained by cardiac failure or fluid overload

Chest imaging

• Berlin Definition: Bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules. (Illustrative clinical cases and chest radiographs have been provided.)
• PARDS: Chest imaging findings of new infiltrate(s) consistent with acute pulmonary parenchymal disease

Oxygenation

• Berlin Definition: Mild: 200 mm Hg < PaO2/FIO2 ≤300 mm Hg with PEEP, or CPAP ≥5 cm H2O Moderate: 100 mm Hg < PaO2 /FIO2 ≤200 mm Hg with PEEP ≥5 cm H2O Severe: PaO2 /FIO2 <100 mm Hg with PEEP ≥5 cm H2O
• PARDS — Noninvasive mechanical ventilation: PARDS (No severity stratification) Full face-mask bilevel ventilation or CPAP >5 cm H2O PF ratio <300 SF ratio <264
• PARDS — Invasive mechanical ventilation: Mild: 4 < OI <8, or 5 < OSI <7.5d Moderate: 8 < OI <16, or 7.5 < OSI <12.3d Severe: OI >16, or OSI >12.3d