At what Berlin ARDS severity does escalation therapy become indicated?

Mild ARDS (P/F 200-300): optimize PEEP, consider NIV. Moderate ARDS (P/F 100-200): prone positioning if P/F =16h/day, 48h NMB, early ECMO center referral if P/F remains <80 despite above measures.

How does rescue therapy differ for moderate vs severe ARDS?

Moderate (P/F 100-150): prone positioning, high PEEP, NMB, lung recruitment maneuvers. Severe (P/F <100): all of the above plus inhaled nitric oxide (bridge to ECMO), high-frequency oscillatory ventilation (HFOV, controversial after OSCILLATE trial), ECMO (EOLIA trial: 28-day mortality trend favoring ECMO). Each escalation step should be tried before the next.

ARDS Berlin Severity Stratification Tool

Stratify ARDS severity using Berlin 2012 P/F ratio thresholds combined with PEEP requirement and clinical trajectory to determine escalation to prone positioning, ECMO referral, and paralytic agent use.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Each component has a specific meaning:

Berlin 2012 P/F ratio thresholds combined — The berlin 2012 p/f ratio thresholds combined recorded for the scenario being assessed.

Note: Interpret the ards berlin severity result against the thresholds and context described above.

How to Use

Enter the Berlin 2012 P/F ratio thresholds combined for the scenario you are assessing. Stratify ARDS severity using Berlin 2012 P/F ratio thresholds combined with PEEP requirement and clinical trajectory to determine escalation to prone positioning, ECMO referral, and paralytic agent use. Use the ards berlin severity result to inform your calculation.

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