title: Temporal evolution of acute respiratory distress syndrome definitions.
abstract: OBJECTIVE
  to review the evolution of acute respiratory distress syndrome (ARDS) definitions and present the current definition for the syndrome.
  
  
  METHODS
  a literature review and selection of the most relevant articles on ARDS definitions was performed using the MEDLINE®/PubMed® Resource Guide database (last ten years), in addition to including the most important articles (classic articles) that described the disease evolution.
  
  
  RESULTS
  the review included the following subjects: introduction; importance of definition; description of the first diagnostic criterion and subsequently used definitions, such as acute lung injury score; definition by the American-European Consensus Conference, and its limitations; description of the definition by Delphi, and its problems; accuracy of the aforementioned definitions; description of most recent definition (the Berlin definition), and its limitations; and practical importance of the new definition.
  
  
  CONCLUSIONS
  ARDS is a serious disease that remains an ongoing diagnostic and therapeutic challenge. The evolution of definitions used to describe the disease shows that studies are needed to validate the current definition, especially in pediatrics, where the data are very scarce.
authors.affiliation: Pediatrics Department, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São Paulo, SP, Brazil; Sociedade Paulista de Terapia Intensiva, São Paulo, SP, Brazil. Electronic address: jrf@fmb.unesp.br.
authors.forename: José R
authors.initials: JR
authors.lastname: Fioretto
authors.forename: Werther B
authors.initials: WB
authors.lastname: Carvalho
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis*; D000328:Adult; D002648:Child; D003245:Consensus Statements as Topic; D003697:Delphi Technique; D006801:Humans; D015278:Intensive Care Units, Pediatric; D012128:Respiratory Distress Syndrome / Q000145:classification / Q000175:diagnosis*; D012307:Risk Factors; D012720:Severity of Illness Index; D009626:Terminology as Topic; D013997:Time Factors
keywords: Acute lung injury; Acute respiratory distress syndrome; Children; Crianças; Definition; Definição; Lesão pulmonar aguda; Pediatric ICU; Síndrome do desconforto respiratório agudo; UTI Pediátrica