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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BackgroundInfluential
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“The ARDS was defined as an acute onset, bilateral infiltrates with PaO2/FiO2 ratio 200 without the evidence of elevated left atrial pressure.(12) The AKI was defined as per RIFLE criteria.”
Method
Psychiatric Illness Is Common Among Patients with Orthopaedic Polytrauma and Is Linked with Poor Outcomes
Weinberg, D. S., Narayanan, A. S., Boden, K. A., Breslin, M. A., & Vallier, H. A. (2016) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.15.00751 · Cited by 126
Biological Phenotyping in Sepsis and Acute Respiratory Distress Syndrome
Sinha, P., Meyer, N. J., & Calfee, C. S. (2022) · Annual Review of Medicine · doi:10.1146/annurev-med-043021-014005 · Cited by 128
Pulmonary Edema Fluid from Patients with Early Lung Injury Stimulates Fibroblast Proliferation through IL-1β-Induced IL-6 Expression
Olman, M. A., White, K. E., Ware, L. B., Simmons, W. L., Benveniste, E. N., Zhu, S., Pugin, J., & Matthay, M. A. (2004) · The Journal of Immunology · doi:10.4049/jimmunol.172.4.2668 · Cited by 125
Multiple Mechanisms of Lung Surfactant Inhibition
Holm, B. A., Wang, Z., & Notter, R. H. (1999) · Pediatric Research · doi:10.1203/00006450-199907000-00015 · Cited by 124
HYPERBARIC OXYGEN FOR THE TREATMENT OF FOURNIER’S GANGRENE
Mindrup, S. R., Kealey, G. P., & Fallon, B. (2005) · The Journal of Urology · doi:10.1097/01.ju.0000158129.56571.05 · Cited by 124
Imbalance between matrix metalloproteinases (MMP-9 and MMP-2) and tissue inhibitors of metalloproteinases (TIMP-1 and TIMP-2) in acute respiratory distress syndrome patients
Lanchou, J., Corbel, M., Tanguy, M., Germain, N., Boichot, E., Théret, N., Clément, B., Lagente, V., & Mallédant, Y. (2003) · Critical Care Medicine · doi:10.1097/01.ccm.0000048626.02184.f8 · Cited by 124
Initial severity of metabolic acidosis predicts the development of acute lung injury in severely traumatized patients
Eberhard, L. W., Morabito, D. J., Matthay, M. A., Mackersie, R. C., Campbell, A. R., Marks, J. D., Alonso, J. A., & Pittet, J. (2000) · Critical Care Medicine · doi:10.1097/00003246-200001000-00021 · Cited by 124
The Impact of Intravenous Fat Emulsion Administration in Acute Lung Injury
Lekka, M. E., Liokatis, S., Nathanail, C., Galani, V., & Nakos, G. (2003) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200305-620oc · Cited by 126
Pharmacotherapy of Acute Lung Injury and Acute Respiratory Distress Syndrome
Raghavendran, K., Pryhuber, G., Chess, P. R., Davidson, B. A., Knight, P. R., & Notter, R. H. (2008) · Current Medicinal Chemistry · doi:10.2174/092986708785132942 · Cited by 124
Acute exacerbation of idiopathic pulmonary fibrosis: high-resolution CT scores predict mortality
Fujimoto, K., Taniguchi, H., Johkoh, T., Kondoh, Y., Ichikado, K., Sumikawa, H., Ogura, T., Kataoka, K., Takahiro, E. N. D. O., Kawaguchi, A., et al. (2011) · European Radiology · doi:10.1007/s00330-011-2211-6 · Cited by 127
Diabetes, insulin, and development of acute lung injury
Honiden, S., & Gong, M. N. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181a0fea5 · Cited by 125
Large-Animal Models of Acute Respiratory Distress Syndrome
Ballard‐Croft, C., Wang, D., Sumpter, L. R., Zhou, X., & Zwischenberger, J. B. (2012) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2011.06.107 · Cited by 126
Dose-Response to Inhaled Aerosolized Prostacyclin for Hypoxemia Due to ARDS
van Heerden, P. V., Barden, A. E., Michalopoulos, N., Bulsara, M. K., & Roberts, B. (2000) · CHEST Journal · doi:10.1378/chest.117.3.819 · Cited by 123
Role for macrophage migration inhibitory factor in acute respiratory distress syndrome
Lai, K. N., Leung, J. C. K., Metz, C. N., Lai, F. M., Bucala, R., & Lan, H. Y. (2003) · The Journal of Pathology · doi:10.1002/path.1291 · Cited by 123
Acute Respiratory Distress Syndrome Caused by Pulmonary and Extrapulmonary Injury: A Comparative CT Study
Desai, S. R., Wells, A. U., Suntharalingam, G., Rubens, M. B., Evans, T. W., & Hansell, D. M. (2001) · Radiology · doi:10.1148/radiology.218.3.r01mr31689 · Cited by 123
Prognostic Value of the Pulmonary Dead-Space Fraction During the First 6 Days of Acute Respiratory Distress Syndrome
Kallet, R. H., Alonso, J. A., Pittet, J., & Matthay, M. A. (2004) · Respiratory Care · doi:10.4187/respcare.04491008 · Cited by 123
C5a Mediates Peripheral Blood Neutrophil Dysfunction in Critically Ill Patients
Morris, A. C., Kefala, K., Wilkinson, T. S., Dhaliwal, K., Farrell, L., Walsh, T. S., MacKenzie, S. J., Reid, H., Davidson, D. J., Haslett, C., et al. (2009) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200812-1928oc · Cited by 123
Self-citation
Analysis of Volatile Disease Markers in Blood
Miekisch, W., Schubert, J. K., Vagts, D. A., & Geiger, K. K. (2001) · Clinical Chemistry · doi:10.1093/clinchem/47.6.1053 · Cited by 122
Latent class analysis-derived subphenotypes are generalisable to observational cohorts of acute respiratory distress syndrome: a prospective study
Sinha, P., Delucchi, K., Chen, Y., Zhuo, H., Abbott, J. A., Wang, C., Wickersham, N. E., McNeil, J. B., Jauregui, A., Ke, S., et al. (2021) · Thorax · doi:10.1136/thoraxjnl-2021-217158 · Cited by 120
“Likewise, in EARLI, the 3- variable and 4- variable models had AUCs≥0.93 in both the AECC and Berlin cohorts (online supplemental figures S5A,B).”
MethodInfluential
Hepatocyte Growth Factor and Keratinocyte Growth Factor in the Pulmonary Edema Fluid of Patients with Acute Lung Injury: Biologic and Clinical Significance
Verghese, G. M., McCormick‐Shannon, K., Mason, R. J., & Matthay, M. A. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.158.2.9711111 · Cited by 122
Intensive care unit support and Acute Physiology and Chronic Health Evaluation III performance in hematopoietic stem cell transplant recipients*
Afessa, B., Tefferi, A., Dunn, W. F., Litzow, M. R., & Peters, S. G. (2003) · Critical Care Medicine · doi:10.1097/01.ccm.0000065761.51367.2d · Cited by 121
Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Intensive Care Medicine · doi:10.1007/s00134-021-06506-y · Cited by 5,082
Risk factors for depression and anxiety in survivors of acute respiratory distress syndrome
Hopkins, R. O., Key, C. W., Suchyta, M. R., Weaver, L. K., & Orme, J. F. (2009) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2009.11.003 · Cited by 121
Accurate characterization of extravascular lung water in acute respiratory distress syndrome*
Berkowitz, D. M., Danai, P. A., Eaton, S., Moss, M. M., & Martin, G. S. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181743eeb · Cited by 121
Corticosteroids and Transition to Delirium in Patients With Acute Lung Injury*
Schreiber, M. P., Colantuoni, E., Bienvenu, O. J., Neufeld, K. J., Chen, K., Shanholtz, C. B., Méndez-Téllez, P. A., & Needham, D. M. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000247 · Cited by 122
“Given the known short- and longterm morbidity and mortality associated with delirium in the ICU, these findings should be considered when weighing potential risk and benefits of using systemic corticosteroids in patients with ALI.”
BackgroundMethodInfluential
Effect of an enteral diet enriched with eicosapentaenoic acid, gamma-linolenic acid and anti-oxidants on the outcome of mechanically ventilated, critically ill, septic patients
Grau-Carmona, T., Morán-García, V., García-de-Lorenzo, A., Heras-de-la-Calle, G., Quesada-Bellver, B., López-Martínez, J., González-Fernández, C., Montejo-González, J. C., Blesa-Malpica, A., Albert-Bonamusa, I., et al. (2011) · Clinical Nutrition · doi:10.1016/j.clnu.2011.03.004 · Cited by 121
Bronchiectasis: Mechanisms and Imaging Clues of Associated Common and Uncommon Diseases
Milliron, B., Henry, T. S., Veeraraghavan, S., & Little, B. P. (2015) · Radiographics · doi:10.1148/rg.2015140214 · Cited by 121
“—Acute respiratory distress syndrome, as defined by the American-European Consensus Conference on Acute Respiratory Distress Syndrome, is the acute onset of arterial hypoxemia resistant to oxygen therapy (ratio of arterial oxygen partial pressure to fractional inspired oxygen, <200 mm Hg), in combination with diffuse…”
Acute lung injury and the acute respiratory distress syndrome in the injured patient
Bakowitz, M., Bruns, B. R., & McCunn, M. (2012) · Scandinavian Journal of Trauma Resuscitation and Emergency Medicine · doi:10.1186/1757-7241-20-54 · Cited by 123
Clinical safety of platelets photochemically treated with amotosalen HCl and ultraviolet A light for pathogen inactivation: the SPRINT trial
Snyder, E. L., McCullough, J., Slichter, S. J., Strauss, R. G., Lopez‐Plaza, I., Lin, J., Corash, L., Conlan, M. G., & SPRINT Study Group (2005) · Transfusion · doi:10.1111/j.1537-2995.2005.00639.x · Cited by 121
What Is Acute Lung Injury?
Schuster, D. P. (1995) · CHEST Journal · doi:10.1378/chest.107.6.1721 · Cited by 121
Predictors of hospital mortality in a population-based cohort of patients with acute lung injury*
Cooke, C. R., Kahn, J. M., Caldwell, E., Okamoto, V. N., Heckbert, S. R., Hudson, L. D., & Rubenfeld, G. D. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e318170a375 · Cited by 120
Self-citation
High values of the pulmonary artery wedge pressure in patients with acute lung injury and acute respiratory distress syndrome
Ferguson, N. D., Meade, M. O., Hallett, D. C., & Stewart, T. E. (2002) · Intensive Care Medicine · doi:10.1007/s00134-002-1354-y · Cited by 120

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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