title: Comparison of the Berlin definition with the American European consensus definition for acute respiratory distress syndrome in burn patients.
abstract: OBJECTIVE
  Acute respiratory distress syndrome (ARDS) is a leading cause of mortality in burn patients. Smoke inhalation, pneumonia and inflammation process are the major causes of ARDS in burn patients. The American European Consensus Conference (AECC) definition proposed in 1994 has recently been revised by the Berlin definition. Our objective was to describe the epidemiology of ARDS comparing the Berlin definition with the AECC definition in a retrospective cohort of burn patients.
  
  
  METHODS
  We reviewed admitted burn adult patients for a two year period, and investigated patient who received mechanical ventilation for more than 48 h and in whom pneumonia was diagnosed.
  
  
  RESULTS
  40 patients were analyzed. According to the AECC definition, 11 patients met criteria for ALI (27.5%), and 29 patients for ARDS (72.5%). According to the Berlin definition, all patients met criteria for ARDS: 4 (10%) for a severe ARDS, 25 (62.5%) for a moderate ARDS, 11 (27.5%) for a mild ARDS. Inhalation injury was diagnosed in 10 patients (25%). Categorizing patients with the Berlin definition showed statistically significative difference of mortality within the three groups, but not with the AECC definition.
  
  
  CONCLUSIONS
  The Berlin definition seems to be more accurate than the AECC definition to assess the severity of ARDS in term of outcome in burn patients. This definition may facilitate prompt recognition of ARDS in burn patients, and promote protective ventilation strategy to a larger number of patients.
authors.affiliation: Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France. Electronic address: bordes.julien@neuf.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Bordes
authors.affiliation: Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lacroix
authors.affiliation: Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Esnault
authors.affiliation: Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Goutorbe
authors.affiliation: Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Cotte
authors.affiliation: Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Dantzer
authors.affiliation: Sainte Anne Military Teaching Hospital, Burn Centre, Toulon, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Meaudre
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055371:Acute Lung Injury / Q000175:diagnosis / Q000209:etiology; D002056:Burns / Q000150:complications; D015331:Cohort Studies; D007249:Inflammation / Q000150:complications; D011014:Pneumonia / Q000150:complications; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015208:Smoke Inhalation Injury / Q000150:complications; D003245:Consensus Statements as Topic
keywords: Acute respiratory distress syndrome; Berlin definition; Burn; Inhalation injury