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Table 2 Berlin definition of acute respiratory distress syndrome

From: The INVENT COVID trial: a structured protocol for a randomized controlled trial investigating the efficacy and safety of intravenous imatinib mesylate (Impentri®) in subjects with acute respiratory distress syndrome induced by COVID-19

Timing Within 1 week of a known clinical insult or new or worsening respiratory symptoms
Chest imaginga Bilateral opacities—not fully explained by effusions, lobar/lung collapse, or nodules
Origin of edema Respiratory failure not fully explained by cardiac failure or fluid overload.
Need objective assessment (e.g., echocardiography) to exclude hydrostatic edema if no risk factors present
Oxygenationb  
 Mild 200 mmHg < PaO2/FIO2 ≤ 300 mmHg with PEEP or CPAP ≥ 5 cmH2Oc
 Moderate 100 mmHg < PaO2/FIO2 ≤ 200 mmHg with PEEP ≥ 5 cmH2O
 Severe PaO2/FIO2 ≤ 100 mmHg with PEEP ≥ 5 cmH2O
  1. Abbreviations: CPAP, continuous positive airway pressure; FIO2, fraction of inspired oxygen; PaO2, partial pressure of arterial oxygen; PEEP, positive end-expiratory pressure
  2. aChest radiograph or computed tomography scan
  3. bIf altitude is higher than 1000 m, the correction factor should be calculated as follows: [PaO2/FIO2 − (barometric pressure/760)]
  4. cThis may be delivered noninvasively in the mild acute respiratory distress syndrome group
  5. Reproduced from: ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012;307:2526-33