Comparis on of the American -European Consensus Conference and Berlin criteria for caute respiratory distress syndrome

doi:10.3969/j.issn.1002-1949.2015.06.005

Abstract：Objective To compare the effectiveness of American -European Consensus Conference ( AECC) and Berlin criteria in predicting the mortality of acute respiratory distress syndrome patients.Methods The data of patients who admitted to intensive care unit ( ICU) of Cancer Hospital Chinese Academy of Medical Sciences were retrospectively reviewed and analyzed.Results There were 25 acute lung injury and 68 acute respiratory distress syndrome ( ARDS) patients according to AECC criteria.Compared with acute lung injury patients, patients who diagnosed as ARDS had more severe disease (APACHEⅡ score 14.50 ±7.87 vs 14.42 ±4.40, P =0.004), higher positive end -expiratory pressure level [(5.14 ±0.38)cm H2O vs (6.20 ±2.17)cm H2O, P=0.048], higher ICU mortality (4.0%vs 31.2%, P=0.014) and hospital mortality (8.0%vs 31.2%, P=0.042).There were 25 mild ARDS,64 moderate and 4 severe ARDS patients.Compared with mild ARDS, patients who were diagnosed as moderate or severe ARDS had more severe disease ( APACHEⅡ score14.50 ± 7.87 vs 15.47 ±6.21 vs 16.50 ±3.70; P=0.016), higher positive end-expiratory pressure level [(5 .14 ±0.38)cm H2O vs (5.71 ±1.49)cm H2O vs (9.00 ±3.61) cm H2O, P=0.048], higher ICU mortality (4.0%vs 31.2%vs 50.0%, P=0.014) and hospital mortality (8.0% vs 31.2% vs 50.0%, P=0.042).Receiver operating curve analysis showed that area under the receiver operating curve was 0.650 ±0 .059 (95%CI 0.533~0.766, P=0.032) for AECC criteria and 0.665 ±0.060 (95%CI 0.548~0.781, P=0.018) for Berlin criteria in predicting ICU mortality.Conclusion Both AECC and Berlin criteria can stratify acute lung injury or ARDS patients by ventilator index and clinical outcomes.Berlin criteria may well guide clinical practice and scientific research due to its more accurate staging of ARDS.