ARDS Subphenotypes as a Guide to Therapy and Enrollment into Therapeutic Trials: Not So Fast

Acute respiratory distress syndrome (ARDS) is a common and highly heterogeneous condition in the critically ill. The association between hyper- and hypo-inflammatory subphenotypes and clinical outcomes has generated significant interest in precise ARDS management. The value of identifying biomarkers to guide treatment and enrollment in future ARDS trials is undisputable. We describe multiple factors complicating the search for subphenotypes and their treatable traits. The observed heterogeneity seen in the clinical course of ARDS is dynamic and influenced by factors beyond lung pathophysiology, including variations in the delivery of best critical care practices, patient comorbidities, and functional status, and patient or family preferences. Current subphenotype definitions lack strong biological plausibility and without clear evidence of benefit from targeted treatments, their use in clinical practice is currently unwarranted.

Authors

Institutions

Publication Details

Journal
Journal of Clinical Medicine
Published
2025-08-28
DOI
https://doi.org/10.3390/jcm14176088
Citations
2
Primary Topic
Respiratory Support and Mechanisms
Type
article
Field-Weighted Citation Impact
3.04

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

ARDS Subphenotypes as a Guide to Therapy and Enrollment into Therapeutic Trials: Not So Fast

Alexander S. Niven, Tamás Szakmány, Diego Casali, Sara Cazorla-Rivero et al.
2 citations
Journal of Clinical Medicine
Respiratory Support and Mechanisms
3.04
article

ARDS Subphenotypes as a Guide to Therapy and Enrollment into Therapeutic Trials: Not So Fast

Alexander S. Niven, Tamás Szakmány, Diego Casali, Sara Cazorla-Rivero, Jesús Villar, Ognjen Gajic
article en
2 citations

Abstract

Acute respiratory distress syndrome (ARDS) is a common and highly heterogeneous condition in the critically ill. The association between hyper- and hypo-inflammatory subphenotypes and clinical outcomes has generated significant interest in precise ARDS management. The value of identifying biomarkers to guide treatment and enrollment in future ARDS trials is undisputable. We describe multiple factors complicating the search for subphenotypes and their treatable traits. The observed heterogeneity seen in the clinical course of ARDS is dynamic and influenced by factors beyond lung pathophysiology, including variations in the delivery of best critical care practices, patient comorbidities, and functional status, and patient or family preferences. Current subphenotype definitions lack strong biological plausibility and without clear evidence of benefit from targeted treatments, their use in clinical practice is currently unwarranted.

Journal of Clinical MedicineVol. 14(17)
Universidad de Las Palmas de Gran Canaria (ES), St. Michael's Hospital (CA), Mayo Clinic (US), Instituto de Salud Carlos III (ES), Hospital Universitario de Gran Canaria Doctor Negrín (ES), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), Abu Dhabi Health Services (AE), Fundación Canaria de Investigación Sanitaria (ES), Abu Dhabi Falcon Hospital (AE), Instituto de Investigación de Enfermedades Raras (ES)
National Science Foundation, National Institute for Health and Care Research, Instituto de Salud Carlos III
Openalex Percentile: Top 8%
Respiratory Support and Mechanisms
3.04
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.