Unifying Concepts

Diagnostic Criteria for Adult Respiratory Distress Syndrome (ARDS)

Acute Respiratory Distress Syndrome (ARDS) is a syndrome of inflammation and increased permeability associated with a constellation of clinical, radiologic, and physiologic abnormalities unexplained by elevations in left atrial or pulmonary capillary pressure.

All definitions of this syndrome include patients who meet the following criteria:

  • Identifiable associated condition

  • Acute onset

  • Pulmonary artery wedge pressure </=18 mm Hg or absence of clinical evidence of left atrial hypertension

  • Bilateral infiltrates on chest radiography

  • Acute lung injury (ALI) is present if Pao2/Fio2 ratio is </= 300

  • Acute respiratory distress syndrome is present if Pao2/Fio2 ratio </= 200

ARDS = acute respiratory distress syndrome; Pao2 = partial pressure of arterial oxygen; Fio2 = percentage of inspired oxygen.

Clinical Conditions Associated with Development of Acute Respiratory Distress Syndrome

Direct lung injury

  • Pneumonia

  • Aspiration of gastric contents

  • Inhalation injury

  • Near drowning

  • Pulmonary contusion

  • Fat embolism

  • Reperfusion pulmonary edema post lung transplantation or pulmonary embolectomy

Indirect lung injury

  • Sepsis

  • Severe trauma

  • Acute pancreatitis

  • Cardiopulmonary bypass

  • Massive transfusions

  • Drug overdose



  1. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):818-24. [Medline]
  2. Ware LB, Matthay MA. The acute respiratory distress syndrome. N Engl J Med. 2000 May 4;342(18):1334-49. [Medline]
  3. Mortelliti MP, Manning HL. Acute respiratory distress syndrome. Am Fam Physician. 2002 May 1;65(9):1823-30. [Medline]


Created: Apr 24, 2005
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