New Definition Categorizes ARDS by Hypoxemia Severity

There were apparent problems with the old AECC consensus conference definition of ARDS. There was some uncertainty about the oxygenation criteria, the differentiation between acute lung injury and ARDS, and the timing criteria for acute lung injury. There was some variability in the interpretation of the chest radiographic scores, and the old definition was said to exclude suspected pulmonary edema with a pulmonary artery catheter.

Sherry Boschert/IMNG Medical Media Dr. Marc Moss

These investigators tried to address a few of those issues. The methodology that they used was very innovative, novel, unique, and sound. I think the methodology could be used in other syndromes where people are defined as having the disorder by meeting certain criteria.

This study will improve the generalizability of the research and will make it easier to perform clinical trials for acute lung injury, especially by identifying potential therapies that maybe are only useful for those patients who have the most severe form of ARDS.

In terms of pure clinical practice, I’m not sure that it will make a large change, but it might lead to some uniformity of the definition of ARDS. Also, by publishing a new definition of ARDS in a high-impact journal, this might raise awareness of patients who have ARDS. With increased awareness, clinicians would more readily implement therapies that should be used, such as low tidal volume ventilation or a fluid-conservative strategy once the patient is hemodynamically stable.

Dr. Marc Moss is professor of medicine and head of critical care at the University of Colorado, Denver. He reported having no relevant disclosures.