Berlin Criteria for Acute Respiratory Distress Syndrome (ARDS)
2012 Berlin Definition of ARDS. Classifies ARDS severity (mild/moderate/severe) based on PaO₂/FiO₂ ratio while on PEEP ≥5 cmH₂O. Replaces the American-European Consensus Conference definition.
Score interpretation
→ Severe ARDS: PaO₂/FiO₂ ≤100 mmHg. Predicted mortality ~46%. ICU; lung-protective ventilation (TV 6 mL/kg IBW, Pplat <30 cmH₂O); prone positioning ≥16h/day; neuromuscular blockade; consider ECMO if refractory.
→ Moderate ARDS: PaO₂/FiO₂ 101–200 mmHg. Predicted mortality ~36%. Lung-protective ventilation; high PEEP strategy; prone positioning; daily ventilator weaning trials.
→ Mild ARDS: PaO₂/FiO₂ 201–300 mmHg. Predicted mortality ~27%. Lung-protective ventilation; optimise PEEP; treat underlying cause; conservative fluid management; early physiotherapy.
→ Does not meet Berlin criteria for ARDS. Evaluate for cardiogenic pulmonary oedema, pneumonia, atelectasis, or pleural disease. Ensure all criteria are present before applying ARDS management protocols.
Interpretation bands for the Berlin ARDS. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Withdrawal Assessment Tool (WAT-1) for Paediatric Iatrogenic Withdrawal · Critical Care
- Oxygenation Index (OI) · Critical Care
- Paediatric Early Warning Score (PEWS) · Critical Care
- Paediatric Fluid Resuscitation Calculator · Critical Care
- Paediatric Index of Mortality 3 (PIM3) · Critical Care
- Berlin Criteria for ARDS · Critical Care
- Poractant Alfa (Porcine Surfactant) · Lung Surfactant (Respiratory Distress Syndrome — Neonatal)
- Dexamethasone (ICU / ARDS) · Systemic Corticosteroid
- Doxapram hydrochloride · Respiratory stimulant
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Milrinone · Inodilator / Acute Heart Failure
- Acute Asthma in Adults · BTS/SIGN British Guideline on Asthma 2019; NICE NG80
- Pulmonary Embolism Assessment · NICE NG158; ESC 2019 PE Guidelines
- Acute Exacerbation of COPD (AECOPD) · NICE NG115; GOLD 2024
- Spontaneous Pneumothorax (Adult) · BTS Pleural Disease 2023
- Atypical Pneumonia (Legionella / Mycoplasma / Chlamydophila) · BTS 2023; IDSA
- COPD Exacerbation Management · NICE NG115 / GOLD 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.