Identifying a hyperinflammatory subphenotype of ARDS associated with worse outcomes: may ferritin help?

Attributable mortality of acute respiratory distress syndrome (ARDS) is considerable.1 2 Yet, no survival benefit has been shown in randomised controlled trials (RCTs) of pharmacological strategies to treat ARDS. This is assumed to be a consequence of the heterogeneity of clinical and biological processes among patients meeting criteria for ARDS.3 In an attempt to address heterogeneity, recent efforts have led to elucidation of the role of respiratory microbiome4 and to identification both in patients at risk of ARDS5 and in patients with ARDS6 of reproducible subphenotypes, such as the ‘hypoinflammatory’ and ‘hyperinflammatory’ subphenotypes; the latter being associated with worse outcomes. Those subphenotypes were identified through post hoc analyses of clinical and plasma biomarker data of patients enrolled in RCTs or in observational studies.5 6 Implementation of subphenotypes in clinical practice has so far...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Thorax Editorial Source Type: research