Berlin Criteria

The Berlin criteria are the criteria most commonly used to define ARDS. All four of the following conditions must be met

• Acute onset: respiratory failure within one week of a known predisposing factor (e.g., sepsis, pneumonia) or worsening respiratory symptoms

• Bilateral opacities (on chest x-ray or CT)

  • Similar appearance to pulmonary edema

  • Not sufficiently explained by pleural effusions, lobar or lung collapse, or nodules

• Hypoxemia: PaO2/FiO2 ≤ 300 mm Hg (measured with a minimum of 5 cm H2O PEEP)

  • Mild ARDS: PaO2/FiO2 = 201–300 mm Hg

  • Moderate ARDS: PaO2/FiO2 = 101–200 mm Hg

  • Severe ARDS: PaO2/FiO2 ≤ 100 mm Hg

• Respiratory failure cannot be fully accounted for by heart failure or fluid overload.