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Highly Accessed Editorial

The Berlin definition: real change or the emperor's new clothes?

Charles R Phillips

Author Affiliations

Department of Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, UHN-67, Portland, OR 97239, USA

Critical Care 2013, 17:174  doi:10.1186/cc12761

Published: 1 August 2013

First paragraph (this article has no abstract)

The Berlin consensus group met recently after 18 years of defining acute respiratory distress syndrome (ARDS) using the American European Consensus Committee (AECC) criteria because, in their words, 'a number of issues regarding various criteria of the AECC definition have emerged, including a lack of explicit criteria for defining acute, sensitivity of PaO2/FiO2 to different ventilator settings, poor reliability of the chest radiograph (CXR) criterion, and difficulties distinguishing hydrostatic edema' [1]. Save for defining acute, they arrived at a new definition using nearly these exact same criteria and thus did not answer their original concerns.