Respiratory failure & ventilation
Identification of novel sub-phenotypes of severe acute respiratory distress syndrome (ARDS) requiring ECMO using latent class analysis
Authors' conclusion
The three sub-phenotypes showed different mortality rates and different relationships between higher PEEP settings in the early phase of V-V ECMO and patient outcomes.
Study context
- Population
- Adults with severe ARDS treated by V–V ECMO
- Participants
- 544 adults
- Exposure
- Sub-phenotypes of severe ARDS on V-V ECMO
- Dry typen = 185
- Wet typen = 169
- Fibrotic typen = 190
- Outcome
- In-hospital mortality by sub-phenotype
- Follow-up
- 90 days
Methodological detailslatent class analysis, multivariate Cox regression
- Latent class analysis
- Multivariate Cox regression
Main finding
As reported in the abstract
90-day in-hospital mortality
Adjusted hazard ratio (95% CI)P value
Fibrotic type vs Dry type
1.75(1.10–2.79)
P = 0.019Fibrotic type vs Wet type
1.50(1.02–2.23)
P = 0.042Observational data: associations, not effects.
Further findings
PEEP ≥ 10 cmH2O during first 3 days of ECMO and 90-day in-hospital mortality, by sub-phenotype (subgroup)
- Interaction Wet type × PEEP ≥ 10 cmH2O
- P for interaction = 0.036
- PEEP ≥ 10 cmH2O decreased mortality risk only in Wet type, not in Dry or Fibrotic type
Original publication
Identification of novel sub-phenotypes of severe ARDS requiring ECMO using latent class analysis. Crit Care. Published 24 October 2024. doi:10.
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