Respiratory failure & ventilation
Biological subphenotypes in severe acute hypoxaemic respiratory failure and acute respiratory distress syndrome using rapid prospective classification (SPARC) in the USA: a multicentre, observational, study
Authors' conclusion
Rapid real-time biological subphenotyping for ARDS and severe AHRF in a multisite US hospital network is feasible; and successful real-time subphenotyping both improved over the study time-course and was completed within 2.2 h from study blood collection.
Study context
- Population
- Adults with acute respiratory distress syndrome (ARDS) or severe acute hypoxaemic respiratory failure (<48 h) on mechanical ventilation, NIV or HFNO ≥30 L/min, 17 US hospitals in the ISPY COVID Network844 screened
- Participants
- 338 adults
- Exposure
- Acute hypoxaemic respiratory failure (AHRF) vs ARDS
- AHRFn = 124
- ARDSn = 214
- Outcome
- Feasibility: successful real-time biological subphenotyping (IL-6, TNFR1, clinical variables) in >75% of the final 100 enrolled participants
Methodological detailsmulticentre, feasibility
- Multicentre
- Feasibility
Main finding
As reported in the abstract
First 100 enrolled participants
59%
Last 100 enrolled participants (feasibility threshold met)
82%
Overall cohort successfully subphenotyped
74%
Observational data: associations, not effects.
Further findings
Hyperinflammatory subphenotype prevalence
Time to subphenotype assignment from blood collection
h
- Overall cohort, median (IQR 1.5-19.8)
- 2.2
- Successfully subphenotyped, median (IQR 1.3-2.3)
- 1.9
Mortality, organ support-free days, ventilator-free days (ARDS)
- Worse in hyperinflammatory vs hypoinflammatory ARDS
Original publication
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