🫁 Berlin ARDS Severity Classification
Berlin definition of ARDS, classifying severity by PaO₂/FiO₂ measured under PEEP/CPAP ≥ 5 cmH₂O.
Oxygenation must be assessed under PEEP/CPAP ≥ 5 cmH₂O, or the P/F-based severity is invalid (original synthesis · not guideline verbatim).
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When to use
Use to confirm the ARDS definition and classify mild/moderate/severe to guide ventilatory strategy.
How it works
All four criteria required (acute onset ≤ 1 week, bilateral infiltrates, not fully cardiac/volume, PEEP/CPAP ≥ 5); severity by P/F: mild 200–300, moderate 100–200, severe ≤ 100.
Key points
- Oxygenation must be assessed under PEEP/CPAP ≥ 5 cmH₂O, or the P/F-based severity is invalid (original synthesis · not guideline verbatim).
- ARDS is a clinical syndrome — the three non-oxygenation criteria must also be satisfied, excluding pure cardiogenic edema.
- Severe ARDS (P/F ≤ 100) is where prone positioning, neuromuscular blockade, and ECMO referral are most relevant.
References
- ARDS Definition Task Force. Berlin definition. JAMA 2012.
- Fan E, et al. ATS/ESICM/SCCM ARDS guideline. Am J Respir Crit Care Med 2017.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| PaO₂/FiO₂ (with PEEP/CPAP ≥ 5) | 150 mmHg |
|---|
→ClassModerate ARDS
- P/F：150 mmHg
- In-hospital mortality (approx.)：≈32%
Frequently asked questions
- What is Berlin ARDS Severity Classification?
- Berlin definition of ARDS, classifying severity by PaO₂/FiO₂ measured under PEEP/CPAP ≥ 5 cmH₂O.
- How is Berlin ARDS Severity Classification calculated? What is the core formula?
- All four criteria required (acute onset ≤ 1 week, bilateral infiltrates, not fully cardiac/volume, PEEP/CPAP ≥ 5); severity by P/F: mild 200–300, moderate 100–200, severe ≤ 100.
- When is Berlin ARDS Severity Classification used?
- Use to confirm the ARDS definition and classify mild/moderate/severe to guide ventilatory strategy.
- What are the key clinical points for Berlin ARDS Severity Classification?
- Oxygenation must be assessed under PEEP/CPAP ≥ 5 cmH₂O, or the P/F-based severity is invalid (original synthesis · not guideline verbatim). ARDS is a clinical syndrome — the three non-oxygenation criteria must also be satisfied, excluding pure cardiogenic edema. Severe ARDS (P/F ≤ 100) is where prone positioning, neuromuscular blockade, and ECMO referral are most relevant.
- What are the limits and cautions when using Berlin ARDS Severity Classification?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Berlin ARDS Severity Classification calculated in practice? Can you show a worked example?
- Inputs: PaO₂/FiO₂ (with PEEP/CPAP ≥ 5) 150 mmHg → Result: Class Moderate ARDS（P/F: 150 mmHg, In-hospital mortality (approx.): ≈32%）