🫁 Berlin ARDS Severity Classification
Berlin definition of ARDS, classifying severity by PaO₂/FiO₂ measured under PEEP/CPAP ≥ 5 cmH₂O.
Berlin ARDS Severity Classification
PaO₂/FiO₂ (with PEEP/CPAP ≥ 5) (mmHg)
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.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.