What are the Berlin ARDS severity categories?

Mild ARDS: PF ratio 200-300 with PEEP ≥5; Moderate: PF ratio 100-200 with PEEP ≥5; Severe: PF ratio <100 with PEEP ≥5; all require bilateral opacities on CXR/CT not explained by effusions/collapse/nodules.

How is predicted body weight calculated for lung protective ventilation?

Males: PBW = 50 + 0.91(height cm - 152.4); Females: PBW = 45.5 + 0.91(height cm - 152.4); tidal volume 6 mL/kg PBW (range 4-8); never use actual body weight (leads to large VT in obese patients).

What driving pressure target reduces ARDS mortality?

Driving pressure = Pplat - PEEP; driving pressure <14-15 cmH2O is associated with lower mortality in retrospective analyses; minimizing driving pressure is the mechanical rationale for using the ARDSnet PEEP/FiO2 tables.

When should prone positioning be used in ARDS?

Prone positioning for ≥16 hours/day in severe ARDS (PF <150) reduces 28-day mortality (PROSEVA trial: 16% vs 32.8%); initiate within 36 hours of ARDS diagnosis; contraindications: spine instability, severe facial trauma, open chest.

What is the role of ECMO in refractory ARDS?

Venovenous ECMO for severe ARDS (PF <80 with PF <150 and pH <7.25 despite optimization) provides gas exchange support allowing ultra-protective ventilation; CESAR and EOLIA trials support selective ECMO use in expert centers.

ARDS Berlin Classification and Lung Protective Ventilation Calculator

Applies Berlin ARDS criteria (PaO2/FiO2 with PEEP ≥5 cmH2O, bilateral infiltrates, non-cardiac origin), calculates predicted body weight for 6 mL/kg tidal volume, driving pressure, and plateau pressure targets.

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Frequently Asked Questions

What are the Berlin ARDS severity categories?

How is predicted body weight calculated for lung protective ventilation?

What driving pressure target reduces ARDS mortality?

When should prone positioning be used in ARDS?

What is the role of ECMO in refractory ARDS?