2012 Berlin definition[edit]

In 2012, the Berlin Definition of ARDS was devised by the European Society of Intensive Care
Medicine, and was endorsed by the American Thoracic Society and the Society of Critical Care
Medicine. These recommendations were an effort to both update classification criteria in order to
improve clinical usefulness and to clarify terminology. Notably, the Berlin guidelines discourage the
use of the term "acute lung injury" or ALI, as the term was commonly being misused to characterize
a less severe degree of lung injury. Instead, the committee proposes a classification of ARDS
severity as mild, moderate, or severe according to arterial oxygen saturation. [13] The Berlin definitions
represent the current international consensus guidelines for both clinical and research classification
of ARDS.[citation needed]

Terminology[edit]
ARDS is the severe form of acute lung injury (ALI), and of transfusion-related acute lung
injury (TRALI), though there are other causes. The Berlin definition included ALI as a mild form of
ARDS.[48] However, the criteria for the diagnosis of ARDS in the Berlin definition excludes many
children, and a new definition for children was termed pediatric acute respiratory distress syndrome
(PARDS); this is known as the PALICC definition (2015). [49][50]

Research directions[edit]
There is ongoing research on the treatment of ARDS by interferon (IFN) beta-1a to aid in preventing
leakage of vascular beds. Traumakine (FP-1201-lyo) is a recombinant human IFN beta-1a drug,
developed by the Finnish company Faron Pharmaceuticals, which is undergoing international phase-
III clinical trials after an open-label, early-phase trial showed an 81% reduction-in-odds of 28-day
mortality in ICU patients with ARDS.[51] The drug is known to function by enhancing
lung CD73 expression and increasing production of anti-inflammatory adenosine, such that vascular
leaking and escalation of inflammation are reduced. [52]
Aspirin has been studied in those who are at high risk and was not found to be useful. [1]
An intravenous ascorbic acid treatment was tested in the 2019 RCT, in people with ARDS due to
sepsis and there was no change in primary endpoints.