The Latest in Critical Care, 6/26/23 (Issue #6)
An expert panel broadened the definition of acute respiratory distress syndrome (ARDS).
They announced this at the American Thoracic Society meeting in May 2023. Thirty-two experts virtually to update the 2012 update (in Berlin), and declared that ARDS shall henceforth include anyone with:
PaO2/FiO2 ≤300 mmHg (on an arterial blood gas) or
SpO2/FiO2 ≤315mmHg with SpO2 ≤97% (on pulse oximetry without an ABG)
That’s while receiving either mechanical ventilation, or (this is new):
High flow nasal oxygen ≥30 L/min, or
Noninvasive ventilation/CPAP with at least 5 cm H2O end-expiratory pressure
Bilateral opacities are still part of the definition, but can now be identified by ultrasound (this is new), as well as CT or radiography.
The prior requirement for mechanical ventilation excluded patients on high-flow oxygen, whose use has expanded dramatically.
A more expansive definition also enlarges the eligible population for studies, including in low-resource environments, formerly called developing…
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