Respiratory failure & ventilation

Defining and subphenotyping acute respiratory distress syndrome (ARDS): insights from an international Delphi expert panel

Lancet Respir MedPublished Delphi consensus study

Authors' conclusion

The findings underscore the need to refine the ARDS definition to better account for the heterogeneity of clinical presentations and underlying pathophysiology, and to improve diagnostic precision, including the use of subphenotyping where appropriate.

Study context

Population
Experts in ARDS research and management from diverse geoeconomic regions and professional backgrounds
Outcome
Consensus on the conceptual model of ARDS, its defining components for clinical, research and educational contexts, and the role of subphenotyping
Methodological detailsPosition Paper, four-round Delphi, international expert panel, panellist anonymity, quantitative consensus criteria, Four Delphi rounds; panellist anonymity and clear quantitative criteria used to mitigate peer pressure and group conformity
  • Position Paper
  • Four-round Delphi
  • International expert panel
  • Panellist anonymity
  • Quantitative consensus criteria
  • Four Delphi rounds; panellist anonymity and clear quantitative criteria used to mitigate peer pressure and group conformity

Recommendations

As reported in the abstract

  • Consensus achieved for the conceptual model of ARDS
  • Consensus achieved on key components of an ARDS definition for research, education and patient management
  • Consensus achieved on the need for further research in subphenotyping ARDS

Further findings

Knowledge gaps and research priorities highlighted to guide future investigations

Original publication

Defining and subphenotyping ARDS: insights from an international Delphi expert panel. Lancet Respir Med. Published 29 April 2025. doi:10.1016/s2213-2600(25)00115-8

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