Observational studyCritical care (London, England)2020
Peripheral blood transcriptomic sub-phenotypes of pediatric acute respiratory distress syndrome.
Observational study in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed.
- Inflammatory and tissue injury marker dynamics in pediatric acute respiratory distress syndrome.The Journal of clinical investigation · 2024Trial
- Observational
- Multi-omics analysis reveals distinct spatial compartmentalization of lung repair niches in pediatric ARDS.Journal of translational medicine · 2025Article
- Prognostic Relevance of Inflammatory Subphenotypes in Immunocompromised Patients With Sepsis.Critical care medicine · 2025Observational
- Transcriptomic signatures of neonatal acute respiratory distress syndrome in a prospective cohort of respiratory distress.iScience · 2025Article
- Advancing omics technologies in acute respiratory distress syndrome: paving the way for personalized medicine.Intensive care medicine experimental · 2025Review
- Biological basis of critical illness subclasses: from the bedside to the bench and back again.Critical care (London, England) · 2024Review
- Whole blood transcriptomics identifies subclasses of pediatric septic shock.Critical care (London, England) · 2023Article
- 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
- Biological Phenotyping in Sepsis and Acute Respiratory Distress Syndrome.Annual review of medicine · 2023Review
- Identification of a pediatric acute hypoxemic respiratory failure signature in peripheral blood leukocytes at 24 hours post-ICU admission with machine learning.Frontiers in pediatrics · 2023Article
- Article
- Application of Machine Learning for Clinical Subphenotype Identification in Sepsis.Infectious diseases and therapy · 2022Article
- Article
- Research Progress on Phenotypic Classification of Acute Respiratory Distress Syndrome: A Narrative Review.International journal of general medicine · 2022Review
- 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
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundAcute respiratory distress syndrome (ARDS) is heterogeneous and may be amenable to sub-phenotyping to improve enrichment for trials. We aimed to identify subtypes of pediatric ARDS based on whole blood transcriptomics.
methodsThis was a prospective observational study of children with ARDS at the Children's Hospital of Philadelphia (CHOP) between January 2018 and June 2019. We collected blood within 24 h of ARDS onset, generated expression profiles, and performed k-means clustering to identify sub-phenotypes. We tested the association between sub-phenotypes and PICU mortality and ventilator-free days at 28 days using multivariable logistic and competing risk regression, respectively.
resultsWe enrolled 106 subjects, of whom 96 had usable samples. We identified three sub-phenotypes, dubbed CHOP ARDS Transcriptomic Subtypes (CATS) 1, 2, and 3. CATS-1 subjects (n = 31) demonstrated persistent hypoxemia, had ten subjects (32%) with immunocompromising conditions, and 32% mortality. CATS-2 subjects (n = 29) had more immunocompromising diagnoses (48%), rapidly resolving hypoxemia, and 24% mortality. CATS-3 subjects (n = 36) had the fewest comorbidities and also had rapidly resolving hypoxemia and 8% mortality. The CATS-3 subtype was associated with lower mortality (OR 0.18, 95% CI 0.04-0.86) and higher probability of extubation (subdistribution HR 2.39, 95% CI 1.32-4.32), relative to CATS-1 after adjustment for confounders.
conclusionsWe identified three sub-phenotypes of pediatric ARDS using whole blood transcriptomics. The sub-phenotypes had divergent clinical characteristics and prognoses. Further studies should validate these findings and investigate mechanisms underlying differences between sub-phenotypes.
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