Evidence map›Paper›PMID 42432748›Full record

ArticleJournal of intensive care2026

The relationship between the chronological phases of diffuse alveolar damage and clinical outcomes in acute respiratory distress syndrome.

Ko-Wei Chang, Chi-Hsien Huang, Shaw-Woei Leu, Tzu-Hsuan Chiu, Hsin-Yueh Fang, Huang-Pin Wu, Li-Pang Chuang, Wei-Hsun Chen, Chien-Hung Chiu, Ning-Hung Chen and 2 more

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Article in Journal of intensive care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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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

12 authors.

Ko-Wei ChangDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan.
Chi-Hsien HuangDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan.
Shaw-Woei LeuDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan.
Tzu-Hsuan ChiuDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan.
Hsin-Yueh FangSchool of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
Huang-Pin WuDivision of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
Li-Pang ChuangDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan.
Wei-Hsun ChenSchool of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
Chien-Hung ChiuDivision of Thoracic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Ning-Hung ChenDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan.
Chung-Chi HuangDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan.
Han-Chung HuDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, 5, Fu-Shin St., Kwei-Shan, Taoyuan, 333, Taiwan. h3226@cgmh.org.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiffuse alveolar damage (DAD) represents the hallmark histopathological feature of acute respiratory distress syndrome (ARDS); however, its prognostic significance remains unclear. This study aimed to evaluate the associations between the chronological phases of histologically confirmed DAD and clinical outcomes in patients with ARDS.

methodsIn this retrospective study, we included patients diagnosed with ARDS who underwent open lung biopsy between January 2002 and December 2025 or transbronchial lung cryobiopsy between January 2017 and December 2025. Rapid progression was defined as the presence of the proliferative phase within 7 days or the fibrotic phase within 21 days from ARDS diagnosis to lung biopsy.

resultsA total of 90 patients were included in the analysis. No significant differences were observed in 28-day mortality (36.5% vs. 43.5%, p = 0.556) or 60-day mortality (63.5% vs. 69.9%, p = 0.601) between patients in the proliferative and fibrotic phases. In contrast, patients with rapid progression demonstrated significantly higher 28-day mortality (47.9% vs. 23.8%, p = 0.018) and 60-day mortality (72.9% vs. 50.0%, p = 0.025) than those without rapid progression. Multivariable analysis identified rapid progression as an independent predictor of 60-day mortality (hazard ratio, 2.274; p = 0.014). Furthermore, patients with rapid progression had significantly lower PaCO

conclusionRapid progression of DAD was associated with significantly poorer clinical outcomes, and patients with rapid progression had significantly lower PaCO

Indexed as

Acute respiratory distress syndromeDiffuse alveolar damageLung biopsy

Identifiers

PMID42432748
PMCPMC13520162

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