ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2019
Evidence of Endotypes in Pediatric Acute Hypoxemic Respiratory Failure Caused by Sepsis.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Identification of phenotypes in paediatric patients with acute respiratory distress syndrome: a latent class analysis.The Lancet. Respiratory medicine · 2022Trial
- Pediatric critical illness endotypes reveal distinct outcomes and immune pathways shared across cause of illness.iScience · 2025Article
- Potential biomarkers used for risk estimation of pediatric sepsis-associated organ dysfunction and immune dysregulation.Pediatric research · 2025Review
- Amyloid-β and caspase-1 are indicators of sepsis and organ injury.ERJ open research · 2024Article
- Pathobiology, Severity, and Risk Stratification of Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2023Review
- Understanding clinical and biological heterogeneity to advance precision medicine in paediatric acute respiratory distress syndrome.The Lancet. Respiratory medicine · 2023Review
- Article
- Cluster analysis and profiling of airway fluid metabolites in pediatric acute hypoxemic respiratory failure.Scientific reports · 2021Article
- Machine Learning-Based Discovery of a Gene Expression Signature in Pediatric Acute Respiratory Distress Syndrome.Critical care explorations · 2021Article
- A Data Report on the Curation and Development of a Database of Genes for Acute Respiratory Distress Syndrome.Frontiers in genetics · 2021Article
- Endothelial Biomarkers Are Associated With Indirect Lung Injury in Sepsis-Associated Pediatric Acute Respiratory Distress Syndrome.Critical care explorations · 2020Article
- Prognostic and predictive enrichment in sepsis.Nature reviews. Nephrology · 2020Review
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesSubclassification based on clinical or biologic commonalities (endotypes) is one approach to reduce heterogeneity in acute hypoxemic respiratory failure. In adults, biomarker-defined endotypes of respiratory failure have been described, with differential outcome profiles and response to therapy. To date, no studies have tested whether endotypes exist in pediatric acute hypoxemic respiratory failure, although messenger RNA expression-based endotypes have been described in pediatric sepsis. The aim of the present study was to test whether endotypes identified in pediatric sepsis are applicable to pediatric acute hypoxemic respiratory failure.
designSecondary analysis of a previously reported microarray-based study of pediatric sepsis.
settingMultiple PICUs in the United States. PATIENTS: Sixty-seven children with acute hypoxemic respiratory failure caused by sepsis.
interventionsNone. MEASUREMENTS AND MAIN
resultsOf the larger septic shock cohort, 67 met eligibility for acute hypoxemic respiratory failure. Twenty-three subjects were assigned to endotype A, and 44 to endotype B. Subjects assigned to endotype A had over four-fold greater unadjusted 28-day mortality, and nearly three-fold greater rates of complicated course. The association with mortality (odds ratio, 8.0; 95% CI, 1.6-41.0) and complicated course (odds ratio, 4.2; 95% CI, 1.2-14.9) persisted after adjustment for age, severity of illness, and PaO2/FIO2.
conclusionsApplying a previously reported endotyping strategy in children with septic shock identified endotypes of pediatric acute hypoxemic respiratory failure secondary to sepsis, with differential risk for poor outcomes. To our knowledge, this is the first demonstration of endotypes in pediatric respiratory failure. Our results support an investigation into using transcriptomics to identify messenger RNA-based endotypes in a dedicated, well-defined acute hypoxemic respiratory failure cohort.
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