Lung Recruitability Is Better Estimated According to the Berlin Definition of Acute Respiratory Distress Syndrome at Standard 5 cm H2O Rather Than Higher Positive End-Expiratory Pressure

2015 ◽  
Vol 43 (4) ◽  
pp. 781-790 ◽  
Author(s):  
Pietro Caironi ◽  
Eleonora Carlesso ◽  
Massimo Cressoni ◽  
Davide Chiumello ◽  
Onner Moerer ◽  
...  
2011 ◽  
Vol 39 (9) ◽  
pp. 2025-2030 ◽  
Author(s):  
Martin Britos ◽  
Elizabeth Smoot ◽  
Kathleen D. Liu ◽  
B. Taylor Thompson ◽  
William Checkley ◽  
...  

2020 ◽  
Author(s):  
Xiaoqin Liu ◽  
Chun Pan ◽  
Li-Ning Si ◽  
Shijun Tong ◽  
Yi Niu ◽  
...  

Abstract Background Acute respiratory distress syndrome(ARDS) is a common respiratory critical illness. The high altitude hypoxic environment has a great influence on its occurrence and development. Now we lack clear diagnostic definition of high altitude acute respiratory distress syndrome.To verify the application value of Berlin Definition plateau criteria of Acute Respiratory Distress Syndrome in Xining , Qinghai ( 2261m).Methods Retrospective analysis of the clinical data of ARDS patients admitted to the Department of Critical Care Medicine of the Affiliated Hospital of Qinghai University from January 2018 to December 2018. The severity was divided according to the Berlin definition, the plateau standard, and the Zhang standard, and the differences of three standards were compared.Results In this study, 512 patients with mechanical ventilation were selected. 229 patients who met the criteria of Berlin Definition plateau criteria , including 107 patients with mild ARDS (46.72%), 84 moderate patients (36.68%) and 38 severe ARDS patients (16.59%). Among 253 meet Berlin definition patients , 49(19.77%) were mild,148(58.50%) were moderate,and 56 (22.13%) were severe ARDS. There are 204 patients that meet Zhang criteria, among the 204 enrolled patients, 87(42.65%) were ALI and 117(57.35%) were ARDS. The AUROC of the Berlin Definition, the Plateau criteria and Zhang criteria were 0.6675 (95% CI 0.5866-0.7484), 0.6216 (95%CI 0.5317-0.7116) and 0.6050 (95% CI 0.5084-0.7016).Conclusion For Xining, Qinghai, the Berlin Definition Plateau oxygenation index correction criteria can distinguish the severity of ARDS , but it needs to be enlarged and confirmed by multicenter clinical studies.


2018 ◽  
Vol 29 (4) ◽  
pp. 415-425 ◽  
Author(s):  
Dannette A. Mitchell ◽  
Maureen A. Seckel

Acute respiratory distress syndrome continues to have high morbidity and mortality despite more than 50 years of research. The Berlin definition in 2012 established risk stratification based on degree of hypoxemia and the use of positive end-expiratory pressure. The use of prone positioning as a treatment modality has been studied for more than 40 years, with recent studies showing an improvement in oxygenation and decreased mortality. The studies also provide evidence to support the methodology and length of treatment time. Recent guidelines include several ventilator strategies for acute respiratory distress syndrome, including prone positioning. Protocols and procedures discussed in this article ensure successful prone repositioning and prevention of complications related to the procedure itself.


2003 ◽  
Vol 29 (11) ◽  
pp. 1936-1942 ◽  
Author(s):  
Elisa Estenssoro ◽  
Arnaldo Dubin ◽  
Enrique Laffaire ◽  
Héctor S Canales ◽  
Gabriela Sáenz ◽  
...  

2020 ◽  
Author(s):  
Xiaoqin Liu ◽  
Chun Pan ◽  
Li-Ning Si ◽  
Shijun Tong ◽  
Yi Niu ◽  
...  

Abstract BackgroundAcute respiratory distress syndrome(ARDS) is a common respiratory critical illness. The high altitude hypoxic environment has a great influence on its occurrence and development. Now we lack clear diagnostic definition of high altitude acute respiratory distress syndrome.To verify the application value of Berlin Definition plateau criteria of Acute Respiratory Distress Syndrome in Xining , Qinghai ( 2261m).MethodsRetrospective analysis of the clinical data of ARDS patients admitted to the Department of Critical Care Medicine of the Affiliated Hospital of Qinghai University from January 2018 to December 2018. The severity was divided according to the Berlin definition, the plateau standard, and the Zhang standard, and the differences of three standards were compared.ResultsIn this study, 512 patients with mechanical ventilation were selected. 229 patients who met the criteria of Berlin Definition plateau criteria , including 107 patients with mild ARDS (46.72%), 84 moderate patients (36.68%) and 38 severe ARDS patients (16.59%). Among 253 meet Berlin definition patients , 49(19.77%) were mild,148(58.50%) were moderate,and 56 (22.13%) were severe ARDS. There are 204 patients that meet Zhang criteria, among the 204 enrolled patients, 87(42.65%) were ALI and 117(57.35%) were ARDS. The AUROC of the Berlin Definition, the Plateau criteria and Zhang criteria were 0.6675 (95% CI 0.5866-0.7484), 0.6216 (95%CI 0.5317-0.7116) and 0.6050 (95% CI 0.5084-0.7016).ConclusionFor Xining, Qinghai, the Berlin Definition Plateau oxygenation index correction criteria can distinguish the severity of ARDS , but it needs to be enlarged and confirmed by multicenter clinical studies.


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