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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

Related Criteria

Diagnostic Criteria for Sepsis

Definitions for the Terms Bacteremia, Sepsis, Severe Sepsis, Septic Shock, and Other Related Disorders

Diagnostic Criteria for Disseminated Intravascular Coagulation (DIC)



  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]

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Created: April 24, 2005
Last Modified: 10/24/2010

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