ReviewThe Lancet. Respiratory medicine2021
The Berlin definition of acute respiratory distress syndrome: should patients receiving high-flow nasal oxygen be included?
Review in The Lancet. Respiratory medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05948332 (Definition and Management of Right Ventricular Injury in Adult Patients Receiving Extracorporeal Membrane Oxygenation for Respiratory Support Using the Delphi Method), which is not on this map. Cited by 77 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Definition and Management of Right Ventricular Injury in Adult Patients Receiving Extracorporeal Membrane Oxygenation for Respiratory Support Using the Delphi Method: A PRORVnet - Expert Consensus Statements
Who cites it
77 citing papers in PubMed, 1 synthesis or guideline pooled it.
- High-Flow Nasal Oxygen for Severe Hypoxemia: Oxygenation Response and Outcome in Patients with COVID-19.American journal of respiratory and critical care medicine · 2022Pooled it
- Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): a randomised, placebo-controlled trial.The Lancet. Respiratory medicine · 2023Trial
- Anti-Granulocyte-Macrophage Colony-Stimulating Factor Monoclonal Antibody Gimsilumab for COVID-19 Pneumonia: A Randomized, Double-Blind, Placebo-controlled Trial.American journal of respiratory and critical care medicine · 2022Trial
- Article
- Small Interfering RNA (siRNA) as a Targeted Therapy for Acute Respiratory Distress Syndrome: Evidence from Experimental Models.International journal of molecular sciences · 2026Review
- Factors associated with an unfavorable outcome according to age in patients with COVID-19 admitted to intensive care in mainland France during the first three periods of the pandemic: a nationwide cohort study.Frontiers in medicine · 2026Article
- Consensus statement for managing patients with ARDS in low-resource settings: a Delphi study.Annals of intensive care · 2026Article
- The Extracellular Matrix and the Immune System in Acute Lung Injury: Partners in Damage and Repair.Biomedicines · 2025Review
- Increased suPAR Plasma Levels May Indicate Postoperative Sepsis Following Open Thoracoabdominal Aortic Repair.Journal of clinical medicine · 2025Article
- Review
- Acute Respiratory Distress Syndrome Definitions in Adults and Children: A Comparative Narrative Review.Journal of clinical medicine · 2025Review
- Efficiency of a Protective Mode of Mechanical Ventilation in Patients with Severe Traumatic Brain Injury Complicated by Acute Respiratory Distress Syndrome.Brain sciences · 2025Article
- Circulating endothelial signatures correlate with worse outcomes in COVID-19, respiratory failure and ARDS.Critical care (London, England) · 2025Article
- Dual role and clinical application of extracellular vesicles in acute respiratory distress syndrome: Mechanism analysis and translational challenges.World journal of stem cells · 2025Review
- Old and New Definitions of Acute Respiratory Distress Syndrome (ARDS): An Overview of Practical Considerations and Clinical Implications.Diagnostics (Basel, Switzerland) · 2025Review
- Validation of Global Definition of Acute Respiratory Distress Syndrome in COVID-19 Patients: A Retrospective Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Article
- Development and validation of a hypoxemia prediction model in middle-aged and elderly outpatients undergoing painless gastroscopy.Scientific reports · 2025Article
- Mechanisms of impaired alveolar fluid clearance.Anatomical record (Hoboken, N.J. : 2007) · 2025Review
- A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management.Critical care (London, England) · 2025Review
- Evaluating the impact of ESICM 2023 guidelines and the new global definition of ARDS on clinical outcomes: insights from MIMIC-IV cohort data.European journal of medical research · 2025Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The 2012 Berlin definition of acute respiratory distress syndrome (ARDS) provided validated support for three levels of initial arterial hypoxaemia that correlated with mortality in patients receiving ventilatory support. Since 2015, high-flow nasal oxygen (HFNO) has become widely used as an effective therapeutic support for acute respiratory failure, most recently in patients with severe COVID-19. We propose that the Berlin definition of ARDS be broadened to include patients treated with HFNO of at least 30 L/min who fulfil the other criteria for the Berlin definition of ARDS. An expanded definition would make the diagnosis of ARDS more widely applicable, allowing patients at an earlier stage of the syndrome to be recognised, independent of the need for endotracheal intubation or positive-pressure ventilation, with benefits for the testing of early interventions and the study of factors associated with the course of ARDS. We identify key questions that could be addressed in refining an expanded definition of ARDS, the implementation of which could lead to improvements in clinical practice and clinical outcomes for patients.
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