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The Berlin definition of acute respiratory distress syndrome: should patients receiving high-flow nasal oxygen be included?
Matthay, Michael A; Thompson, B Taylor; Ware, Lorraine B.
  • Matthay MA; Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA, USA. Electronic address: michael.matthay@ucsf.edu.
  • Thompson BT; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Ware LB; Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
Lancet Respir Med ; 9(8): 933-936, 2021 08.
Article in English | MEDLINE | ID: covidwho-1413072
ABSTRACT
The 2012 Berlin definition of acute respiratory distress syndrome (ARDS) provided validated support for three levels of initial arterial hypoxaemia that correlated with mortality in patients receiving ventilatory support. Since 2015, high-flow nasal oxygen (HFNO) has become widely used as an effective therapeutic support for acute respiratory failure, most recently in patients with severe COVID-19. We propose that the Berlin definition of ARDS be broadened to include patients treated with HFNO of at least 30 L/min who fulfil the other criteria for the Berlin definition of ARDS. An expanded definition would make the diagnosis of ARDS more widely applicable, allowing patients at an earlier stage of the syndrome to be recognised, independent of the need for endotracheal intubation or positive-pressure ventilation, with benefits for the testing of early interventions and the study of factors associated with the course of ARDS. We identify key questions that could be addressed in refining an expanded definition of ARDS, the implementation of which could lead to improvements in clinical practice and clinical outcomes for patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen Inhalation Therapy / Respiratory Insufficiency / COVID-19 Type of study: Diagnostic study / Prognostic study Limits: Humans Language: English Journal: Lancet Respir Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Oxygen Inhalation Therapy / Respiratory Insufficiency / COVID-19 Type of study: Diagnostic study / Prognostic study Limits: Humans Language: English Journal: Lancet Respir Med Year: 2021 Document Type: Article