Revised ARDS definition sets out levels of severity

An international task force this week unveiled a revised definition of acute respiratory distress syndrome (ARDS), a disease first recognized during the Vietnam War in casualties with limb injuries who had trouble breathing.

The new definition includes a distinction between the most serious cases of ARDS and cases that are less advanced, said Antonio Anzueto, M.D., of UT Medicine San Antonio, a who served on the ARDS Definition Task Force. The guidelines are based on evidence from data of more than 4,000 patients with ARDS, including 200 from San Antonio.

Awareness that ARDS is starting

The guidelines, called the Berlin Definition, are described in the . This paper represents a more vigilant approach to identification and diagnosis of ARDS, which doesn't necessarily begin in the lungs, Dr. Anzueto said. "This new stratification of severity will make clinicians aware the process is starting and interventions have to be applied almost immediately to prevent the disease from progressing," he said.

UT Medicine is the clinical practice of the School of Medicine at The University of Texas Science Center San Antonio. Dr. Anzueto, professor of medicine at the Health Science Center and section chief of pulmonary diseases at the South Texas Veterans , participated in an ARDS network established by the National Institutes of Health and has studied the disease for 15 years.

'White lung'

Vietnam casualties presented with lungs that were white on X-rays, and an early name for ARDS was "white lung." As many as 8 in every 10 patients died with the disease. In the 1980s a consensus conference was convened to clinically define ARDS and the research network began. New understandings about managing the disease have cut the mortality rate by more than half.

"We are learning that even though patients are surviving ARDS there are long-term consequences," Dr. Anzueto said. "Generalized weakness, emotional abnormalities and post-traumatic stress disorder are among these."

Data for review

University Hospital, a level one trauma center in San Antonio and teaching hospital of the Health Science Center, is a leading hospital for treatment of the disease. Dr. Anzueto's group contributed data to the revised definition from patients managed in the South Texas Veterans Health Care System and University Hospital.

"This is evidence-based; it is not our opinion sitting at a table smoking cigars," Dr. Anzueto said.

Factors hinder care

ARDS continues to be difficult to treat, he said, in part because conditions such as diabetes, obesity and heart disease are impacting the disease in many patients.

The JAMA article coincides with the panel's presentation of the Berlin on May 23 at the American Thoracic Society 2012 Conference in San Francisco.

More information: Study link: jama.jamanetwork.com/article.a… px?articleID=1160659

add to favorites email to friend print save as pdf

Related Stories

ARDS mortality is unchanged since 1994

Jan 23, 2009

Mortality in patients with acute respiratory distress syndrome (ARDS) has not fallen since 1994, according to a comprehensive review of major studies that assessed ARDS deaths. This disappointing finding contradicts the common ...

Recommended for you

Mali announces new Ebola case

10 hours ago

Mali announced Saturday a new case of Ebola in a man who is fighting for his life in an intensive care unit in the capital Bamako.

Plague outbreak kills 40 in Madagascar: WHO

10 hours ago

An outbreak of plague has killed 40 people in Madagascar, the World Health Organization said, warning that the disease could spread rapidly in the country's densely populated capital Antananarivo.

UN chief: Ebola cases in Mali a 'deep concern'

Nov 21, 2014

The United Nations chief warned Friday that Ebola may be easing in part of West Africa but is still hitting hard in other areas and outpacing the international response.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.