PANCE Pulmonology Practice Test

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What are the Berlin criteria for diagnosing ARDS?

Acute onset within 1 week; bilateral opacities not due to effusion/failure; respiratory failure not fully explained by cardiac failure; PaO2/FiO2 ≤300 (mild), ≤200 (moderate), ≤100 (severe) on PEEP ≥5.

The Berlin criteria define ARDS by four components: timing, imaging, origin of edema, and oxygenation with severity. It must start within one week of a known insult or new/worsening respiratory symptoms. Chest imaging or CT shows bilateral opacities, not explained solely by effusion, lobar/lung collapse, or nodules. The edema should not be fully explained by cardiac failure or fluid overload. Finally, oxygenation is impaired, assessed with a PaO2/FiO2 ratio while on PEEP or CPAP of at least 5 cm H2O, with severity categorized as mild (200–300), moderate (100–200), or severe (≤100).

Acute onset within 1 week; unilateral opacities; PaO2/FiO2 ≤150.

Chronic onset; bilateral opacities; PaO2/FiO2 ≤400.

Acute onset within 2 weeks; bilateral effusions; PaO2/FiO2 ≤50.