Abstract
We read with interest the Article by Giulio Cavalli and colleagues1 in The Lancet Rheumatology about the use of anakinra for patients with acute respiratory distress syndrome (ARDS) related to COVID-19. Although the study by Cavalli and colleagues was not performed in intensive care units (ICUs), the semantics used by the authors derive from critical care practice and need some precision. First, the definition of ARDS necessitates a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2:FiO2) of less than 200 mm Hg for a diagnosis of moderate ARDS and of less than 100 mm Hg for severe ARDS, assessed on invasive mechanical ventilation with a positive end-expiratory pressure of more than 5 cm H2O.
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