ArticleCritical care (London, England)2021
Identification of persistent and resolving subphenotypes of acute hypoxemic respiratory failure in two independent cohorts.
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
9 citing papers in PubMed, 23 citations in OpenAlex.
- Reproducible clinical archetypes in acute respiratory failure: a multi-cohort trajectory analysis.Intensive care medicine · 2026Article
- Alveolar Immune Profiling Identifies Distinct Subphenotypes of Acute Respiratory Failure.medRxiv : the preprint server for health sciences · 2026Article
- Rapidly improving ARDS differs clinically and biologically from persistent ARDS.Critical care (London, England) · 2024Observational
- Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review.Journal of clinical medicine · 2023Review
- Clinical Sepsis Phenotypes in Critically Ill Patients.Microorganisms · 2023Review
- MICROVASCULAR ENDOTHELIAL ACTIVATION/DYSFUNCTION AND DYSREGULATION OF THE ANGIOPOIETIN-TIE2 SYSTEM IN THE PATHOGENESIS OF LIFE-THREATENING INFECTIONS.Transactions of the American Clinical and Climatological Association · 2023Article
- New Insights into Clinical and Mechanistic Heterogeneity of the Acute Respiratory Distress Syndrome: Summary of the Aspen Lung Conference 2021.American journal of respiratory cell and molecular biology · 2022Article
- Pathogenesis of pneumonia and acute lung injury.Clinical science (London, England : 1979) · 2022Review
- Rapidly improving acute respiratory distress syndrome in COVID-19: a multi-centre observational study.Respiratory research · 2022Observational
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAcute hypoxemic respiratory failure (HRF) is associated with high morbidity and mortality, but its heterogeneity challenges the identification of effective therapies. Defining subphenotypes with distinct prognoses or biologic features can improve therapeutic trials, but prior work has focused on ARDS, which excludes many acute HRF patients. We aimed to characterize persistent and resolving subphenotypes in the broader HRF population.
methodsIn this secondary analysis of 2 independent prospective ICU cohorts, we included adults with acute HRF, defined by invasive mechanical ventilation and PaO
resultsOver 50% developed persistent HRF in both the discovery (n = 386) and validation (n = 1032) cohorts. Persistent HRF was associated with higher risk of death relative to resolving HRF in both the discovery (1.68-fold, 95% CI 1.11, 2.54) and validation cohorts (1.93-fold, 95% CI 1.50, 2.47), after adjustment for age, sex, chronic respiratory illness, and acute illness severity on enrollment (APACHE-III in discovery, APACHE-II in validation). Patients with persistent HRF displayed higher biomarkers of inflammation (interleukin-6, interleukin-8) and endothelial dysfunction (angiopoietin-2) than resolving HRF after adjustment. Only half of persistent HRF patients had ARDS, yet exhibited higher mortality and biomarkers than resolving HRF regardless of whether they qualified for ARDS.
conclusionPatients with persistent HRF are common and have higher mortality and elevated circulating markers of lung injury compared to resolving HRF, and yet only a subset are captured by ARDS definitions. Persistent HRF may represent a clinically important, inclusive target for future therapeutic trials in HRF.
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Registered trials
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