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Table 1 Ultimate definition and diagnostic criteria of AE-IPF and ARDS

From: Acute exacerbation of idiopathic pulmonary fibrosis: lessons learned from acute respiratory distress syndrome?

Revised definition Berlin definition
An acute, clinically significant respiratory deterioration characterized by evidence of new widespread alveolar abnormality A type of acute diffuse, inflammatory lung injury, leading to increased pulmonary vascular permeability, increased lung weight, and loss of aerated lung tissue. The clinical hallmarks are hypoxemia and bilateral radiographic opacities, associated with increased venous admixture, increased physiological dead space, and decreased lung compliance. The morphological hallmark of the acute phase is diffuse alveolar damage (i.e., edema, inflammation, hyaline membrane, or hemorrhage)
Diagnostic criteria Definition criteria
Previous or concurrent diagnosis of IPF  
Acute worsening or development of dyspnea typically < 1 month in duration Onset of lung injury within 1 week of a known clinical insult or new or worsening respiratory symptoms
Computed tomography with new bilateral ground-glass opacity and/or consolidation superimposed on a background pattern consistent with usual interstitial pneumonia pattern Bilateral opacities—not fully explained by effusions, lobar/lung collapse, or nodules
Deterioration not fully explained by cardiac failure or fluid overload Respiratory failure not fully explained by cardiac failure or fluid overload
  1. AE-IPF acute exacerbation of idiopathic pulmonary fibrosis, ARDS acute respiratory distress syndrome