Cited by 6,746Respiratory Support and MechanismsNeonatal Respiratory Health ResearchSepsis Diagnosis and Treatment

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The American-European Consensus Conference On Ards. Definitions, Mechanisms, Relevant Outcomes, And Clinical Trial Coordination

Bernard, G R, Artigas, A, Brigham, K L, Carlet, J, Falke, K, Hudson, L, Lamy, M, Legall, J R, Morris, A, Spragg, R·1994·American journal of respiratory and critical care medicine

DOI 10.1164/ajrccm.149.3.7509706

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Abstract

The acute respiratory distress syndrome (ARDS), a process of nonhydrostatic pulmonary edema and hypoxemia associated with a variety of etiologies, carries a high morbidity, mortality (10 to 90%), and financial cost. The reported annual incidence in the United States is 150,000 cases, but this figure has been challenged, and it may be different in Europe. Part of the reason for these uncertainties are the heterogeneity of diseases underlying ARDS and the lack of uniform definitions for ARDS. Thus, those who wish to know the true incidence and outcome of this clinical syndrome are stymied. The American-European Consensus Committee on ARDS was formed to focus on these issues and on the pathophysiologic mechanisms of the process. It was felt that international coordination between North America and Europe in clinical studies of ARDS was becoming increasingly important in order to address the recent plethora of potential therapeutic agents for the prevention and treatment of ARDS.

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Wilkins, P. A., Otto, C. M., Baumgardner, J. E., Dunkel, B., Bedenice, D., Paradis, M. R., Staffieri, F., Syring, R. S., Slack, J., Grasso, S., et al. (2007) · Journal of Veterinary Emergency and Critical Care · doi:10.1111/j.1476-4431.2007.00238.x · Cited by 136
The large spectrum of pulmonary complications following illicit drug use: Features and mechanisms
Mégarbane, B., & Chevillard, L. (2013) · Chemico-Biological Interactions · doi:10.1016/j.cbi.2013.10.011 · Cited by 138
“Acute respiratory distress (ARDS) and acute lung injury (according to the former definition [5]), more recently nominated mild ARDS by the Berlin’s consensus [6] represent the clinical expression of increased alveolar-capillary permeability due to lung inflammation, resulting in the reduction of gas exchange (Table 1).”
Background
Clinical Application of Modest Hypothermia after Spinal Cord Injury
Levi, A. D., Green, B. A., Wang, M. Y., Dietrich, W. D., Brindle, T. I., Vanni, S., Casella, G. T., Elhammady, G., & Jagid, J. R. (2009) · Journal of Neurotrauma · doi:10.1089/neu.2008.0745 · Cited by 136
Association between tidal volume size, duration of ventilation, and sedation needs in patients without acute respiratory distress syndrome: an individual patient data meta-analysis
Neto, A. S., Simonis, F. D., Barbas, C. S. V., Biehl, M., Determann, R. M., Elmer, J., Friedman, G., Gajic, O., Goldstein, J. N., Horn, J., et al. (2014) · Intensive Care Medicine · doi:10.1007/s00134-014-3318-4 · Cited by 136
“Studies or trials were excluded from the analysis if they (1) reported on patients receiving ventilation during general anesthesia for surgery, or (2) included patients with ARDS at onset of ventilation, according to the American–European Consensus criteria [10].”
Method
History of burns: The past, present and the future
Moiemen, N. S., Lee, K., & Joory, K. (2014) · Burns & Trauma · doi:10.4103/2321-3868.143620 · Cited by 136
“Traditionally, mechanical ventilation is acheived using tidal volumes of 10-15 ml per kilogram of body weight which is larger than in normal subjects at rest (7-8 ml per kilogram)([118]), which can lead to an excessive distension of the lung leading to disruption of the pulmonary epithelium and endothelium, and the re…”
Background
Polymorphism of the angiotensin-converting enzyme gene affects the outcome of acute respiratory distress syndrome*
Jerng, J., Yu, C., Wang, H., Chen, K., Cheng, S.-L., & Yang, P. (2006) · Critical Care Medicine · doi:10.1097/01.ccm.0000206107.92476.39 · Cited by 136
De-escalation of antimicrobial treatment in neutropenic patients with severe sepsis: results from an observational study
Mokart, D., Slehofer, G., Lambert, J., Sannini, A., Chow‐Chine, L., Brun, J. P., Berger, P., Duran, S., Faucher, M., Blache, J. L., et al. (2013) · Intensive Care Medicine · doi:10.1007/s00134-013-3148-9 · Cited by 137
Quality of Life, Pulmonary Function, and Tomographic Scan Abnormalities After ARDS
Masclans, J. R., Roca, O., Muñoz, X., Pallisa, E., Torres, F., Rello, J., & Morell, F. (2011) · CHEST Journal · doi:10.1378/chest.10-2438 · Cited by 136
Pulmonary Capillary Endothelium-Bound Angiotensin-Converting Enzyme Activity in Acute Lung Injury
Orfanos, S. E., Armaganidis, A., Glynos, C., Psevdi, E., Kaltsas, P., Sarafidou, P., Catravas, J. D., Dafni, U. G., Langleben, D., & Roussos, C. (2000) · Circulation · doi:10.1161/01.cir.102.16.2011 · Cited by 136
Surfactant Therapy for Acute Lung Injury and Acute Respiratory Distress Syndrome
Raghavendran, K., Willson, D. F., & Notter, R. H. (2011) · Critical Care Clinics · doi:10.1016/j.ccc.2011.04.005 · Cited by 138
Depressed interleukin-12-producing activity by monocytes correlates with adverse clinical course and a shift toward Th2-type lymphocyte pattern in severely injured male trauma patients
Spolarics, Z., Siddiqi, M., Siegel, J. H., Garcia, Z. C., Stein, D., Denny, T. N., & Deitch, E. A. (2003) · Critical Care Medicine · doi:10.1097/01.ccm.0000063579.43470.aa · Cited by 136
Exhaled breath condensate acidification in acute lung injury
Geßner, C., Hammerschmidt, S., Kühn, H., Seyfarth, H., Sack, U., Engelmann, L., Schauer, J., & Wirtz, H. R. W. (2003) · Respiratory Medicine · doi:10.1016/s0954-6111(03)00225-7 · Cited by 136
Bronchoalveolar lavage fluid characteristics of early intermediate and late phases of ARDS
Nakos, G., Kitsiouli, E., Tsangaris, I., & Lekka, M. E. (1998) · Intensive Care Medicine · doi:10.1007/s001340050571 · Cited by 136
Extracranial complications in patients with acute brain injury: a post-hoc analysis of the SOAP study
Mascia, L., Sakr, Y. L., Pasero, D., Payen, D. M., Reinhart, K., Vincent, J., & Sepsis Occurrence in Acutely Ill Patients (SOAP) Investigators (2008) · Intensive Care Medicine · doi:10.1007/s00134-007-0974-7 · Cited by 135
Feasibility and Effectiveness of Prone Position in Morbidly Obese Patients With ARDS
JONG, A. D., Molinari, N., Sebbane, M., Prades, A., Futier, E., Jung, B., Chanques, G., & Jaber, S. (2013) · CHEST Journal · doi:10.1378/chest.12-2115 · Cited by 136
CIRCULATING ANGIOPOIETIN 2 CORRELATES WITH MORTALITY IN A SURGICAL POPULATION WITH ACUTE LUNG INJURY/ADULT RESPIRATORY DISTRESS SYNDROME
Gallagher, D. C., Parikh, S. M., Balonov, K., Miller, A. C., Gautam, S., Talmor, D. S., & Sukhatme, V. P. (2008) · Shock · doi:10.1097/shk.0b013e31815dd92f · Cited by 135
Noninvasive continuous positive airway pressure delivered by helmet in hematological malignancy patients with hypoxemic acute respiratory failure
Principi, T., Pantanetti, S., Catani, F., Elisei, D., Gabbanelli, V., Pelaia, P., & Leoni, P. (2004) · Intensive Care Medicine · doi:10.1007/s00134-003-2056-9 · Cited by 135
Neurogenic Pulmonary Edema in Fatal and Nonfatal Head Injuries
Rogers, F. B., Shackford, S. R., Trevisani, G. T., Davis, J. W., Mackersie, R. C., & Hoyt, D. B. (1995) · doi:10.1097/00005373-199511000-00009 · Cited by 135
Relation between PaO2/FIO2 ratio and FIO2: a mathematical description
Aboab, J., Louis, B., Jonson, B., & Brochard, L. J. (2006) · Intensive Care Medicine · doi:10.1007/s00134-006-0337-9 · Cited by 135
Crystalloid to packed red blood cell transfusion ratio in the massively transfused patient
Neal, M. D., Hoffman, M. K., Cuschieri, J., Minei, J. P., Maier, R. V., Harbrecht, B. G., Billiar, T. R., Peitzman, A. B., Moore, E. E., Cohen, M. J. M., et al. (2012) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e31823d84a7 · Cited by 134
Brain atrophy and cognitive impairment in survivors of acute respiratory distress syndrome
Hopkins, R. O., Gale, S. D., & Weaver, L. K. (2006) · Brain Injury · doi:10.1080/02699050500488199 · Cited by 134
Epidemiology of acute lung injury and acute respiratory distress syndrome
Frutos–Vivar, F., Nín, N., & Esteban, A. (2004) · Current Opinion in Critical Care · doi:10.1097/00075198-200402000-00001 · Cited by 134
Intrahospital transport of critically ill ventilated patients: A risk factor for ventilator-associated pneumonia—A matched cohort study*
Bercault, N., Wolf, M., Runge, I., Fleury, J.-C., & Boulain, T. (2005) · Critical Care Medicine · doi:10.1097/01.ccm.0000185644.54646.65 · Cited by 132
Positive End-Expiratory Pressure Alters Intracranial and Cerebral Perfusion Pressure in Severe Traumatic Brain Injury
Huynh, T. T., Messer, M., Sing, R. F., Miles, W., Jacobs, D. G., & Thomason, M. H. (2002) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/00005373-200209000-00016 · Cited by 131
Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults
Afshari, A., Brok, J. S., Møller, A. M., & Wetterslev, J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002787.pub2 · Cited by 139
A Double-Blind Randomized Controlled Clinical Trial to Assess the Effect of Doppler Optimized Intraoperative Fluid Management on Outcome Following Radical Cystectomy
Pillai, P. L., McEleavy, I., Gaughan, M., Snowden, C. P., Nesbitt, I., Durkan, G. C., Johnson, M. I., Cosgrove, J. F., & Thorpe, A. C. (2011) · The Journal of Urology · doi:10.1016/j.juro.2011.07.093 · Cited by 133
Prehospitalization Antiplatelet Therapy Is Associated With a Reduced Incidence of Acute Lung Injury
Erlich, J. M., Talmor, D. S., Cartin‐Ceba, R., Gajic, O., & Kor, D. J. (2010) · CHEST Journal · doi:10.1378/chest.10-0891 · Cited by 133
Ratio of angiopoietin-2 to angiopoietin-1 as a predictor of mortality in acute lung injury patients
Ong, T., McClintock, D. E., Kallet, R. H., Ware, L. B., Matthay, M. A., & Liu, K. D. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181eaa5bf · Cited by 136
Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses
Tonelli, A. R., Zein, J., Adams, J., & Ioannidis, J. P. A. (2014) · Intensive Care Medicine · doi:10.1007/s00134-014-3272-1 · Cited by 134
“We tried to be all-encompassing and therefore we considered all definitions of ARDS [1, 12].”
Method
Extracellular histone release in response to traumatic injury
Kutcher, M., Xu, J., Vilardi, R. F., Ho, C., Esmon, C. T., & Cohen, M. J. M. (2012) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0b013e318270d595 · Cited by 133

Authors: Bernard, G. R., Artigas, A., Brigham, K. L., Carlet, J., Falke, K., Hudson, L., Lamy, M., Legall, J. R., Morris, A., & Spragg, R.
Affiliations: Vanderbilt University (US)
Vanderbilt University, Nashville, Tennessee
ORCID: Bernard, G R
Artigas, A
Carlet, J
Lamy, M
Morris, A
Venue: American journal of respiratory and critical care medicine
Publisher: Oxford University Press (OUP)
Published: 1994-03-01
Volume: 149
Issue: 3
Pages: 818-824
ISSN: 1073-449X (ISSN-L)
1535-4970
DOI: 10.1164/ajrccm.149.3.7509706
OpenAlex: W2161328469
Cited by: 6,746
References: 20
Citations by year: 2026: 54 · 2025: 112 · 2024: 107 · 2023: 119 · 2022: 126 · 2021: 164 · 2020: 158 · 2019: 184 · 2018: 156 · 2017: 192 · 2016: 238 · 2015: 241 · 2014: 289 · 2013: 341 · 2012: 364
FWCI: 80.47
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/pages/standard-publication-reuse-rights (vor)
Locations: American Journal of Respiratory and Critical Care Medicine (publishedVersion)
PubMed (publishedVersion)
D-Scholarship@Pitt (University of Pittsburgh) (acceptedVersion)
Funders: National Institutes of Health (5r01hl043167-05, 5p50hl019153-22)
National Heart, Lung, and Blood Institute (NHLBI HL19153, NHLBI HL43167)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Keywords: acute respiratory distress syndrome, ARDS definition, ARDS pathophysiology, ARDS incidence, ARDS mortality, clinical trial coordination
MeSH terms: Americas, Clinical Protocols, Clinical Trials as Topic, Europe, Humans, Oxygen Inhalation Therapy, Prognosis, Radiography, Respiratory Distress Syndrome, Risk Factors, Incidence, Prevalence

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The American-European Consensus Conference On Ards. Definitions, Mechanisms, Relevant Outcomes, And Clinical Trial Coordination

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