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Vol. 48. Issue 5.
Pages 272-281 (May 2024)
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Vol. 48. Issue 5.
Pages 272-281 (May 2024)
Review article
Post-pandemic acute respiratory distress syndrome: A New Global Definition with extension to lower-resource regions
Síndrome de distrés respiratorio agudo en la post-pandemia: una nueva definicion global con extensión a regiones de menos recursos
Elisa Estenssoroa,b,1,
Corresponding author

Corresponding author at: Dirección postal: 42 No. 577, La Plata 1900, BA, Argentina.
, Iván Gonzálezc, Gustavo A. Plotnikowc,d
a Escuela de Gobierno en Salud, Ministerio de Salud, Buenos Aires, Argentina
b Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Buenos Aires, Argentina
c Servicio de Rehabilitación, Área de Kinesiología Crítica, Hospital Británico de Buenos Aires, CABA, Argentina
d Facultad de Medicina y Ciencias de la Salud, Universidad Abierta Interamericana, Argentina
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Figures (2)
Tables (4)
Table 1. Risk factors associated with ARDS.
Table 2. Adult respiratory distress syndrome definition, according to Ashbaugh et al.7
Table 3. ARDS different definitions.
Table 4. Diagnostic criteria for the New Global Definition of ARDS.
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Acute respiratory distress syndrome (ARDS), first described in 1967, is characterized by acute respiratory failure causing profound hypoxemia, decreased pulmonary compliance, and bilateral CXR infiltrates. After several descriptions, the Berlin definition was adopted in 2012, which established three categories of severity according to hypoxemia (mild, moderate and severe), specified temporal aspects for diagnosis, and incorporated the use of non-invasive ventilation. The COVID-19 pandemic led to changes in ARDS management, focusing on continuous monitoring of oxygenation and on utilization of high-flow oxygen therapy and lung ultrasound. In 2021, a New Global Definition based on the Berlin definition of ARDS was proposed, which included a category for non-intubated patients, considered the use of SpO2, and established no particular requirement for oxygenation support in regions with limited resources. Although debates persist, the continuous evolution seeks to adapt to clinical and epidemiological needs, and to the search of personalized treatments.

Acute Respiratory Distress Syndrome, ARDS
Acute lung injury
Inflammatory lung edema
Mechanical ventilation

El síndrome de dificultad respiratoria aguda (SDRA), inicialmente descrito en 1967, se caracteriza por insuficiencia respiratoria aguda con hipoxemia profunda, disminución de la distensibilidad pulmonar e infiltrados bilaterales en la Rx de tórax. En 2012 la definición de Berlín, estableció tres categorías en base a la hipoxemia (SDRA leve, moderado y grave), precisando aspectos temporales y permitiendo el diagnóstico con ventilación no invasiva. La pandemia de COVID-19 llevó a reconsiderar la definición, enfocándose en el monitoreo continuo de la oxigenación y la oxigenoterapia de alto flujo. En 2021, se propuso una Nueva Definición Global de SDRA, basada en la definición de Berlín pero incluyendo una categoría para pacientes no intubados, permitiendo el uso de SpO2/FiO2 y la ecografía pulmonar para el diagnóstico, y sin ningún requerimiento de soporte especial de la oxigenación en regiones con recursos limitados. Aunque persisten debates, la evolución continua busca adaptarse a las necesidades clínicas y epidemiológicas, y personalizar tratamientos.

Palabras clave:
Síndrome de Dificultad Respiratoria Aguda, SDRA
Edema pulmonar inflamatorio
Ventilación mecánica


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