Respiratory failure & ventilation
Epithelial injury and inflammatory phenotypes for personalized ventilation in acute respiratory distress syndrome (ARDS): Secondary analysis of the LIVE trial
Authors' conclusion
In ARDS, epithelial injury assessed by plasma sRAGE may identify heterogeneity of treatment effect with lung recruitment, whereas inflammatory phenotypes remained prognostic for mortality.
Study context
- Population
- Patients with focal or non-focal ARDS in the LIVE trial with plasma sRAGE measurements; baseline sRAGE dichotomised at 2,440 pg/mL (high vs low)with plasma sRAGE
- Participants
- 259 patients
- Comparison
- Lung recruitment vs Low PEEP
- Primary endpoint
- 90-day mortality
- Follow-up
- 90 days
Methodological detailsinverse probability weighting, weighted Cox models, joint models
- Inverse probability weighting
- Weighted Cox models
- Joint models
Primary result
As reported in the abstract
90-day mortality by subgroup
Lung recruitment vs Low PEEPHazard ratio (95% CI)P value
high-sRAGE
0.41(0.18–0.93)
P = 0.033low-sRAGE
3.27(1.06–10.1)
P = 0.039- Treatment effect varied by baseline sRAGE
- P for interaction = 0.006
- Treatment effect did not vary by inflammatory phenotype
- P for interaction = 0.56
Secondary outcomes
sRAGE trajectory until day 6
- Lung recruitment: steeper sRAGE decline in high baseline sRAGE
- P for interaction < 0.001
- Lung recruitment: slower sRAGE decline in low baseline sRAGE
- P for interaction = 0.038
90-day mortality, hyperinflammatory vs hypoinflammatory phenotype
- Hyperinflammatory phenotype associated with 90-day mortality (57% vs 26%)
- P < 0.001
Correlation of high plasma sRAGE with non-focal ARDS
- Moderate correlation r=0.26
- P < 0.001
- Inflammatory phenotype not correlated
Original publication
Epithelial injury and inflammatory phenotypes for personalized ventilation in ARDS: Secondary analysis of the LIVE trial. Chest. Published 23 September 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →