Trial reportIntensive care medicine2023
Inflammatory subphenotypes in patients at risk of ARDS: evidence from the LIPS-A trial.
Trial report in Intensive care medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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
16 citing papers in PubMed, 24 citations in OpenAlex.
- The Acute Respiratory Distress Syndrome (ARDS): epidemiology, etiology, molecular mechanisms, diagnosis and therapeutic strategies.Molecular biomedicine · 2026Review
- Moving from Critical Illness Syndromes toward Biologic Molecular Endotypes: Making Progress.American journal of respiratory and critical care medicine · 2025Article
- Clinical Phenotyping in Acute Respiratory Distress Syndrome: Steps Towards Personalized Medicine.Journal of clinical medicine · 2025Article
- Temporal stability of phenotypes of acute respiratory distress syndrome: clinical implications for early corticosteroid therapy and mortality.Intensive care medicine · 2025Article
- The Impact of Inflammatory Biomarker Subphenotypes on Acute Respiratory Distress Syndrome Prognosis: A Systematic Review and Meta-analysis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2025Review
- Efficacy of early pulmonary rehabilitation in severe and critically ill COVID-19 patients: a retrospective cohort study.BMC pulmonary medicine · 2025Article
- Identification and validation of robust hospital-acquired pneumonia subphenotypes associated with all-cause mortality: a multi-cohort derivation and validation.Intensive care medicine · 2025Article
- Subphenotyping prone position responders with machine learning.Critical care (London, England) · 2025Observational
- Association of Albumin-Bilirubin (ALBI) Grade With 28-Day All-Cause Mortality in Patients With Acute Respiratory Distress Syndrome: A Retrospective Analysis of the MIMIC-IV Database.Mediators of inflammation · 2025Article
- Clinical management of sepsis-associated acute respiratory distress syndrome: current evidence and future directions.Frontiers in medicine · 2025Review
- Precision Medicine in Acute Respiratory Distress Syndrome: Progress, Challenges, and the Road ahead.Clinics in chest medicine · 2024Review
- Identification of novel sub-phenotypes of severe ARDS requiring ECMO using latent class analysis.Critical care (London, England) · 2024Observational
- Glucocorticoid therapy for acute respiratory distress syndrome: Current concepts.Journal of intensive medicine · 2024Review
- Ventilator Weaning in Prolonged Mechanical Ventilation-A Narrative Review.Journal of clinical medicine · 2024Review
- Identifying a hyperinflammatory subphenotype of ARDS associated with worse outcomes: may ferritin help?Thorax · 2024Article
- Heterogeneity of immune cells and their communications unveiled by transcriptome profiling in acute inflammatory lung injury.Frontiers in immunology · 2024Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeLatent class analysis (LCA) has identified hyper- and non-hyper-inflammatory subphenotypes in patients with acute respiratory distress syndrome (ARDS). It is unknown how early inflammatory subphenotypes can be identified in patients at risk of ARDS. We aimed to test for inflammatory subphenotypes upon presentation to the emergency department.
methodsLIPS-A was a trial of aspirin to prevent ARDS in at-risk patients presenting to the emergency department. In this secondary analysis, we performed LCA using clinical, blood test, and biomarker variables.
resultsAmong 376 (96.4%) patients from the LIPS-A trial, two classes were identified upon presentation to the emergency department (day 0): 72 (19.1%) patients demonstrated characteristics of a hyper-inflammatory and 304 (80.9%) of a non-hyper-inflammatory subphenotype. 15.3% of patients in the hyper- and 8.2% in the non-hyper-inflammatory class developed ARDS (p = 0.07). Patients in the hyper-inflammatory class had fewer ventilator-free days (median [interquartile range, IQR] 28[23-28] versus 28[27-28]; p = 0.010), longer intensive care unit (3[2-6] versus 0[0-3] days; p < 0.001) and hospital (9[6-18] versus 5[3-9] days; p < 0.001) length of stay, and higher 1-year mortality (34.7% versus 20%; p = 0.008). Subphenotypes were identified on day 1 and 4 in a subgroup with available data (n = 244). 77.9% of patients remained in their baseline class throughout day 4. Patients with a hyper-inflammatory subphenotype throughout the study period (n = 22) were at higher risk of ARDS (36.4% versus 10.4%; p = 0.003).
conclusionHyper- and non-hyper-inflammatory subphenotypes may precede ARDS development, remain identifiable over time, and can be identified upon presentation to the emergency department. A hyper-inflammatory subphenotype predicts worse outcomes.
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