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Respiratory Anaesthesia / Critical Care Emergency Medicine Strong — core component of Berlin ARDS definition (2012)

PaO₂/FiO₂ Ratio (P/F Ratio)

Calculates the ratio of arterial oxygen tension to inspired oxygen fraction. Used to classify severity of hypoxaemic respiratory failure and diagnose ARDS per Berlin criteria.

Score interpretation

Normal Gas Exchange ≥ 300

P/F ratio ≥ 300: Normal. No ARDS.

→ Monitor if on supplemental oxygen. Address underlying cause.

Mild ARDS 200–299

P/F ratio 200–300 with PEEP/CPAP ≥ 5 cmH₂O: Mild ARDS (Berlin).

→ High-flow nasal oxygen or CPAP. Consider HDU/ICU. Identify precipitant: pneumonia, aspiration, sepsis.

Moderate ARDS — ~40% mortality 100–199

P/F ratio 100–199: Moderate ARDS.

→ ICU admission. Lung-protective ventilation (TV 6 mL/kg IBW). PEEP titration. Prone positioning ≥ 16h/day.

Severe ARDS — >45% mortality 0–99

P/F ratio < 100: Severe ARDS.

→ ICU mandatory. Neuromuscular blockade (cisatracurium). Prone positioning. Consider VV-ECMO if refractory.

Interpretation bands for the P/F Ratio. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.