Rethinking Acute Respiratory Distress Syndrome after COVID-19: If a "Better" Definition Is the Answer, What Is the Question?

V Marco Ranieri, Gordon Rubenfeld, Arthur S Slutsky, V Marco Ranieri, Gordon Rubenfeld, Arthur S Slutsky

Abstract

The definition of acute respiratory distress syndrome (ARDS) has a somewhat controversial history, with some even questioning the need for the term "ARDS." This controversy has been amplified by the coronavirus disease (COVID-19) pandemic given the marked increase in the incidence of ARDS, the relatively new treatment modalities that do not fit neatly with the Berlin definition, and the difficulty of making the diagnosis in resource-limited settings. We propose that attempts to revise the definition of ARDS should apply the framework originally developed by psychologists and social scientists and used by other medical disciplines to generate and assess definitions of clinical syndromes that do not have gold standards. This framework is structured around measures of reliability, feasibility, and validity. Future revisions of the definition of ARDS should contain the purpose, the methodology, and the framework for empirically testing any proposed definition. Attempts to revise critical illness syndromes' definitions usually hope to make them "better"; our recommendation is that future attempts use the same criteria used by other fields in defining what "better" means.

Keywords: acute respiratory distress syndrome; definition; framework; validity.

References

    1. Carroll L. Through the looking glass and what Alice found there. London: Macmillan; 1871.
    1. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet . 1967;2:319–323.
    1. Petty TL, Ashbaugh DG. The adult respiratory distress syndrome: clinical features, factors influencing prognosis and principles of management. Chest . 1971;60:233–239.
    1. Streiner DL, Norman GR, Cairney J. Health measurement scales: a practical guide to their development and use. Oxford, UK: Oxford University Press; 2015.
    1. Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, Fan E, et al. ARDS Definition Task Force Acute respiratory distress syndrome: the Berlin definition. JAMA . 2012;307:2526–2533.
    1. Matthay MA, Thompson BT, Ware LB. The Berlin definition of acute respiratory distress syndrome: should patients receiving high-flow nasal oxygen be included? Lancet Respir Med . 2021;9:933–936.
    1. Ware LB. Go with the flow: expanding the definition of acute respiratory distress syndrome to include high-flow nasal oxygen. Am J Respir Crit Care Med . 2022;205:380–382.
    1. Petty TL. Editorial: the adult respiratory distress syndrome (confessions of a “lumper”) Am Rev Respir Dis . 1975;111:713–715.
    1. Murray JF. Editorial: the adult respiratory distress syndrome (may it rest in peace) Am Rev Respir Dis . 1975;111:716–718.
    1. Murray JF, Matthay MA, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis . 1988;138:720–723.
    1. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American–European Consensus Conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med . 1994;149:818–824.
    1. Meade MO, Cook RJ, Guyatt GH, Groll R, Kachura JR, Bedard M, et al. Interobserver variation in interpreting chest radiographs for the diagnosis of acute respiratory distress syndrome. Am J Respir Crit Care Med . 2000;161:85–90.
    1. Rubenfeld GD, Caldwell E, Granton J, Hudson LD, Matthay MA. Interobserver variability in applying a radiographic definition for ARDS. Chest . 1999;116:1347–1353.
    1. Esteban A, Fernández-Segoviano P, Frutos-Vivar F, Aramburu JA, Nájera L, Ferguson ND, et al. Comparison of clinical criteria for the acute respiratory distress syndrome with autopsy findings. Ann Intern Med . 2004;141:440–445.
    1. Ferguson ND, Davis AM, Slutsky AS, Stewart TE. Development of a clinical definition for acute respiratory distress syndrome using the Delphi technique. J Crit Care . 2005;20:147–154.
    1. Riviello ED, Kiviri W, Twagirumugabe T, Mueller A, Banner-Goodspeed VM, Officer L, et al. Hospital incidence and outcomes of the acute respiratory distress syndrome using the Kigali modification of the Berlin definition. Am J Respir Crit Care Med . 2016;193:52–59.
    1. Ranieri VM, Tonetti T, Navalesi P, Nava S, Antonelli M, Pesenti A, et al. High-flow nasal oxygen for severe hypoxemia: oxygenation response and outcome in patients with COVID-19. Am J Respir Crit Care Med . 2022;205:431–439.
    1. Lichtenstein D, Goldstein I, Mourgeon E, Cluzel P, Grenier P, Rouby JJ. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome. Anesthesiology . 2004;100:9–15.
    1. Rice TW, Wheeler AP, Bernard GR, Hayden DL, Schoenfeld DA, Ware LB, National Institutes of Health, National Heart, Lung, and Blood Institute ARDS Network Comparison of the SpO2/FiO2 ratio and the PaO2/FiO2 ratio in patients with acute lung injury or ARDS. Chest . 2007;132:410–417.
    1. Villar J, Perez-Mendez L, Blanco J, Anon JM, Blanch L, Belda J, et al. Spanish Initiative for Epidemiology, Stratification, and Therapies for ARDS (SIESTA) Network A universal definition of ARDS: the PaO2/FiO2 ratio under a standard ventilatory setting—a prospective, multicenter validation study. Intensive Care Med . 2013;39:583–592.
    1. Gattinoni L, Marini JJ. Isn’t it time to abandon ARDS? The COVID-19 lesson. Crit Care . 2021;25:326.
    1. Rubenfeld GD. Epidemiology of acute lung injury. Crit Care Med . 2003;31:S276–S284.
    1. Binning JF. Construct. Chicago: The Britannica Group; 2016.
    1. Feinstein AR. Clinimetrics. New Haven, CT: Yale University Press; 1987.
    1. Allen MJ, Yen WM. Introduction to measurement theory. Long Grove, IL: Waveland Press; 2001.
    1. American Educational Research Association, American Psychological Association, National Council on Measurement in Education, Joint Committee on Standards for Educational and Psychological Testing. Standards for educational and psychological testing. Washington, DC: American Educational Research Association; 2014.
    1. Kendler KS. Toward a scientific psychiatric nosology: strengths and limitations. Arch Gen Psychiatry . 1990;47:969–973.
    1. Green CE, Chen CE, Helms JE, Henze KT. Recent reliability reporting practices in Psychological Assessment: recognizing the people behind the data. Psychol Assess . 2011;23:656–669.
    1. Goddard SL, Rubenfeld GD, Manoharan V, Dev SP, Laffey J, Bellani G, et al. The Randomized Educational Acute Respiratory Distress Syndrome Diagnosis study: a trial to improve the radiographic diagnosis of acute respiratory distress syndrome. Crit Care Med . 2018;46:743–748.
    1. Pesenti A, Musch G, Lichtenstein D, Mojoli F, Amato MBP, Cinnella G, et al. Imaging in acute respiratory distress syndrome. Intensive Care Med . 2016;42:686–698.
    1. Calfee CS, Delucchi K, Parsons PE, Thompson BT, Ware LB, Matthay MA, NHLBI ARDS Network Subphenotypes in acute respiratory distress syndrome: latent class analysis of data from two randomised controlled trials. Lancet Respir Med . 2014;2:611–620.
    1. Kelley TL. Interpretation of educational measurements. New York: Macmillan; 1927.
    1. Luhr OR, Karlsson M, Thorsteinsson A, Rylander C, Frostell CG. The impact of respiratory variables on mortality in non-ARDS and ARDS patients requiring mechanical ventilation. Intensive Care Med . 2000;26:508–517.
    1. Villar J, Mora-Ordoñez JM, Soler JA, Mosteiro F, Vidal A, Ambrós A, et al. The PANDORA study: prevalence and outcome of acute hypoxemic respiratory failure in the pre-COVID-19 era. Crit Care Explor . 2022;4:e0684.
    1. Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med . 2011;9:90.
    1. Thille AW, Esteban A, Fernández-Segoviano P, Rodriguez JM, Aramburu JA, Peñuelas O, et al. Comparison of the Berlin definition for acute respiratory distress syndrome with autopsy. Am J Respir Crit Care Med . 2013;187:761–767.
    1. Shah CV, Lanken PN, Localio AR, Gallop R, Bellamy S, Ma SF, et al. An alternative method of acute lung injury classification for use in observational studies. Chest . 2010;138:1054–1061.
    1. Shah FA, Meyer NJ, Angus DC, Awdish R, Azoulay É, Calfee CS, et al. A research agenda for precision medicine in sepsis and acute respiratory distress syndrome: an official American Thoracic Society research statement. Am J Respir Crit Care Med . 2021;204:891–901.
    1. Nuckton TJ, Alonso JA, Kallet RH, Daniel BM, Pittet JF, Eisner MD, et al. Pulmonary dead-space fraction as a risk factor for death in the acute respiratory distress syndrome. N Engl J Med . 2002;346:1281–1286.
    1. Gattinoni L, Caironi P, Cressoni M, Chiumello D, Ranieri VM, Quintel M, et al. Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med . 2006;354:1775–1786.
    1. Agache I, Akdis CA. Precision medicine and phenotypes, endotypes, genotypes, regiotypes, and theratypes of allergic diseases. J Clin Invest . 2019;129:1493–1503.
    1. Beitler JR, Thompson BT, Baron RM, Bastarache JA, Denlinger LC, Esserman L, et al. Advancing precision medicine for acute respiratory distress syndrome. Lancet Respir Med . 2022;10:107–120.
    1. Angus DC, Seymour CW, Coopersmith CM, Deutschman CS, Klompas M, Levy MM, et al. A framework for the development and interpretation of different sepsis definitions and clinical criteria. Crit Care Med . 2016;44:e113–e121.
    1. Shankar-Hari M, Rubenfeld GD. Just because things are not different, does not mean they are the same: biomarker patterns in acute respiratory distress syndrome. Crit Care Med . 2017;45:1955–1957.

Source: PubMed

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