Evidence map›Paper›PMID 41546094›Full record

ArticleCritical care (London, England)2026

Morphological subphenotypes of acute pancreatitis-related acute respiratory distress syndrome.

Joris Pensier, Maha Touaibia, Mohamad Azhar Meerun, Philippe Hefteh, Nicolas Bloncourt, Aurélie Vonarb, Albert Prades, Bader Al Taweel, Antoine Debourdeau, Laurent Monino and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Is postoperative ARDS different from medical ARDS?Critical care (London, England) · 2026
    Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Joris Pensier *Anesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 180 Avenue Augustin Fliche, Montpellier Cedex 5, Montpellier, France.
Maha Touaibia *Anesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 180 Avenue Augustin Fliche, Montpellier Cedex 5, Montpellier, France.
Mohamad Azhar MeerunDepartment of Diagnostic and Interventional Radiology, Saint-Eloi HospitalInstitut Desbrest d'Epidémiologie Et de Santé PubliqueUMR UA11 INSERM, University Hospital of Montpellier, IDESP, 34090, Montpellier, France.
Philippe HeftehAnesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 180 Avenue Augustin Fliche, Montpellier Cedex 5, Montpellier, France.
Nicolas BloncourtAnesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 180 Avenue Augustin Fliche, Montpellier Cedex 5, Montpellier, France.
Aurélie VonarbDépartement d'Anesthésie Réanimation B (DAR B), 80 Avenue Augustin Fliche, 34295, Montpellier, France.
Albert PradesDépartement d'Anesthésie Réanimation B (DAR B), 80 Avenue Augustin Fliche, 34295, Montpellier, France.
Bader Al TaweelDigestive Surgery and Transplantation, Montpellier University Hospital, University of Montpellier, Montpellier, France.
Antoine DebourdeauGastroenterology Unit, CHU de Montpellier, Montpellier University MUSE, Montpellier, France.
Laurent MoninoGastroenterology Unit, CHU de Montpellier, Montpellier University MUSE, Montpellier, France.
Gérald ChanquesAnesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 180 Avenue Augustin Fliche, Montpellier Cedex 5, Montpellier, France.
Nicolas MolinariDepartement d'informatiqué Medicale, Medical Information, IMAG; CNRS, Centre Hospitaliér Regional, CHRU Montpellier, Institut Désbrest de Santé Publique (IDESP) INSERM, Universite de Montpellier, Montpellier, France.
Audrey de JongAnesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 180 Avenue Augustin Fliche, Montpellier Cedex 5, Montpellier, France.
Boris GuiuDepartment of Diagnostic and Interventional Radiology, Saint-Eloi HospitalInstitut Desbrest d'Epidémiologie Et de Santé PubliqueUMR UA11 INSERM, University Hospital of Montpellier, IDESP, 34090, Montpellier, France.
Samir JaberAnesthesiology and Intensive Care; Anesthesia and Critical Care Department B, Saint Eloi Teaching Hospital, PhyMedExp, University of Montpellier, INSERM U1046, 180 Avenue Augustin Fliche, Montpellier Cedex 5, Montpellier, France. s-jaber@chu-montpellier.fr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute Respiratory Distress Syndrome (ARDS) encompasses heterogenous subphenotypes. We assessed whether morphological subphenotypes of Acute Pancreatitis-related ARDS have differential responses to prone position and positive end-expiratory pressure (PEEP).

methodsWe analyzed a retrospective cohort of all consecutive critically ill adults with Acute Pancreatitis-related ARDS and early CT-scan admitted to ICU from 2003 to 2023. ARDS was classified according to CT-scan as “Focal ARDS” or “Non-Focal ARDS.” The primary outcome was 90-day mortality. Treatment effects for prone position and high PEEP were assessed. Adjusted Hazard Ratios (aHR) were calculated with a multivariate Cox analysis. Machine-learning models were developed with XGBoost and explained with SHAP.

resultsAmong the 5,865 patients screened, 151 Acute Pancreatitis-related ARDS were included in the analysis. Eighty-one patients (54%) were classified as Focal ARDS and 70 patients (46%) as Non-Focal ARDS. There was no significant difference in ARDS management. The overall 90-day mortality was of 37% (56/151). There was no significant difference in 90-day mortality between Focal and Non-Focal ARDS (33/81 [41%] vs 33/70 [34%], adjusted Hazard Ratio (aHR): 1.01 [0.58–1.76], p = 0.98). Prone position was associated with lower 90-day mortality in Focal ARDS (aHR: 0.25 [0.08 – 0.76], p = 0.015) but not in Non-Focal ARDS. High PEEP was associated with lower 90-day mortality in Non-Focal ARDS (aHR: 0.22 [0.06–0.85], p = 0.029) but not in Focal ARDS. Machin-learning models concurred with differential responses to prone position and PEEP.

conclusionTwo morphological subphenotypes of Acute Pancreatitis–related ARDS were identified and were evenly distributed. Although their clinical characteristics and outcomes were comparable, they exhibited treatment-specific responses: prone positioning was associated with lower mortality in Focal ARDS, whereas high PEEP was associated with lower mortality in Non-Focal ARDS. These findings suggest that morphology may help guide personalized ventilatory strategies in this specific ARDS population.

Indexed as

PancreatitisRespiratory Distress SyndromeAgedCohort StudiesFemaleHumansIntensive Care UnitsMaleMiddle AgedPhenotypePositive-Pressure RespirationProne PositionProportional Hazards ModelsRetrospective StudiesAcute pancreatitisAcute respiratory distress syndromeIntensive care unitMachine-learningProne positionSubphenotypes

Identifiers

PMID41546094
PMCPMC12892776

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LicenceCC BY-NC-ND
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Registered trials

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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.