Evidence map›Paper›PMID 38649920›Full record

Observational studyCritical care (London, England)2024

Rapidly improving ARDS differs clinically and biologically from persistent ARDS.

Patricia L Valda Toro, Andrew Willmore, Nelson E Wu, Kevin L Delucchi, Alejandra Jauregui, Pratik Sinha, Kathleen D Liu, Carolyn M Hendrickson, Aartik Sarma, Lucile P A Neyton and 8 more

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 14 citations in OpenAlex.

  1. Review
  2. Is postoperative ARDS different from medical ARDS?Critical care (London, England) · 2026
    Article
  3. Article
  4. Review
  5. Article
  6. Observational
  7. Review
  8. Observational
  9. Multimodal Deep Learning for ARDS Detection.medRxiv : the preprint server for health sciences · 2025
    Article
  10. Review
  11. Development and Validation of an Electronic Health Record-Based, Pediatric Acute Respiratory Distress Syndrome Subphenotype Classifier Model.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025
    Article
  12. Article
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 5 institutions in 2 countries.

Patricia L Valda ToroDepartment of Medicine, Division of Pulmonary and Critical Care, University of Pennsylvania, Philadelphia, PA, USA. Patricia.valdatoro@pennmedicine.upenn.edu.
Andrew WillmoreDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Nelson E WuDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Kevin L DelucchiDepartment of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
Alejandra JaureguiDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Pratik SinhaDepartment of Anesthesiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
Kathleen D LiuDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Carolyn M HendricksonDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Aartik SarmaDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Lucile P A NeytonDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Aleksandra LeligdowiczDepartment of Critical Care Medicine, Toronto Western Hospital, Toronto, Canada.
Charles R LangelierDivision of Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Hanjing ZhuoDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Chayse JonesDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Kirsten N KangelarisDivision of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Antonio D GomezDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Michael A MatthayDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Carolyn S CalfeeDivision of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
University of California, San Francisco · USChan Zuckerberg Initiative (United States) · USToronto Western Hospital · CAUniversity of Pennsylvania · USWashington University in St. Louis · US

Funding

Precision Medicine in the Acute Respiratory Distress SyndromeR35HL140026 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CALFEE, CAROLYN · 2018 to 2024
$6.8M
Precision Medicine in Sepsis with Critical IllnessR35GM142992 · NIGMS · WASHINGTON UNIVERSITY · PI Pratik Sinha · 2021 to 2026
$2.4M
Evolution and resolution of ARDS molecular phenotypesK23HL163491 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Aartik Sarma · 2023 to 2026
$750k
NHLBI NIH HHS K23 HL163491NHLBI NIH HHS R35 HL140026NIGMS NIH HHS R35 GM142992NIH HHS R35 HL140026
6 · The paper itself

Abstract

backgroundRapidly improving acute respiratory distress syndrome (RIARDS) is an increasingly appreciated subgroup of ARDS in which hypoxemia improves within 24 h after initiation of mechanical ventilation. Detailed clinical and biological features of RIARDS have not been clearly defined, and it is unknown whether RIARDS is associated with the hypoinflammatory or hyperinflammatory phenotype of ARDS. The purpose of this study was to define the clinical and biological features of RIARDS and its association with inflammatory subphenotypes.

methodsWe analyzed data from 215 patients who met Berlin criteria for ARDS (endotracheally intubated) and were enrolled in a prospective observational cohort conducted at two sites, one tertiary care center and one urban safety net hospital. RIARDS was defined according to previous studies as improvement of hypoxemia defined as (i) PaO

resultsRIARDS accounted for 21% of all ARDS participants. Patients with RIARDS had better clinical outcomes compared to those with persistent ARDS, with lower hospital mortality (13% vs. 57%; p value < 0.001) and more ICU-free days (median 24 vs. 0; p value < 0.001). Plasma levels of interleukin-6, interleukin-8, and plasminogen activator inhibitor-1 were significantly lower among patients with RIARDS. The hypoinflammatory phenotype of ARDS was more common among patients with RIARDS (78% vs. 51% in persistent ARDS; p value = 0.001).

conclusionsThis study identifies a high prevalence of RIARDS in a multicenter observational cohort and confirms the more benign clinical course of these patients. We report the novel finding that RIARDS is characterized by lower concentrations of plasma biomarkers of inflammation compared to persistent ARDS, and that hypoinflammatory ARDS is more prevalent among patients with RIARDS. Identification and exclusion of RIARDS could potentially improve prognostic and predictive enrichment in clinical trials.

Indexed as

BiomarkersRespiration, ArtificialRespiratory Distress SyndromeAdultAgedCohort StudiesFemaleHumansHypoxiaMaleMiddle AgedProspective StudiesBiomarkersAcute respiratory distress syndromeHypoinflammatory and hyperinflammatory ARDS phenotypesPrecision medicinePrognostic and predictive enrichment of clinical trialsRapidly improving acute respiratory distress syndrome

Identifiers

PMID38649920
PMCPMC11034037
OpenAlexW4395005341

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.