Thread by @SarinaKS

Well it's finally here. New Global Definition of ARDS presented by Michael Matthay on behalf of a large diverse international panel.

More of a modification than a new definition. Berlin lives on but includes new patients under the ARDS umbrella

#ATS2023
@ATSCritCare

Consensus process:
100% agreement that Berlin definition need an update

100% agreement on recommendations (after many meetings)

Input without requirement for formal endorsement from 21 critical care societies.

Things have changed since 2012 Berlin definition.

More HFNC use, less ABG use, and less ultrasound use.

Our practice of respiratory failure patients has changed, our definitions need to evolve also

Advantages and disadvantages of including HFNC > 30L/min

Advantages and disadvantages of including use of SpO2/FiO2 ratio < 315 when SpO2 < 97% in addition to P/F ratio

If SpO2 > 97% can't use SF ratio.

Advantages and disadvantages of allowing lung ultrasound to diagnose chest infiltrates

Potential benefits of the Global ARDS definition:

Treatment at an earlier phase of dz

Understand trajectories starting at earlier phase

Biologic insights may be gained by studying earlier time points

Global research possible when definition can apply to pts in more locations