Respiratory failure & ventilation
Inflammatory subphenotypes in patients at risk of acute respiratory distress syndrome (ARDS): evidence from the LIPS-A trial
Authors' conclusion
Hyper- and non-hyper-inflammatory subphenotypes may precede ARDS development, remain identifiable over time, and can be identified upon presentation to the emergency department. A hyper-inflammatory subphenotype predicts worse outcomes.
Study context
- Population
- Patients at risk of ARDS presenting to the ED (LIPS-A aspirin trial)96.4% of LIPS-A
- Participants
- 376 patients
- Comparison
- Hyper- vs non-hyper-inflammatory subphenotype
- Hyper-inflammatoryn = 72
- Non-hyper-inflammatoryn = 304reference
- Primary endpoint
- Identification of inflammatory subphenotypes upon presentation to the ED
- Follow-up
- Day 0
Methodological detailslatent class analysis
- Latent class analysis
Primary result
As reported in the abstract
Subphenotype prevalence at ED presentation
Further findings
ARDS development
P = 0.07
1-year mortality
P = 0.008
ICU LOS
P < 0.001
Hospital LOS
P < 0.001
Median
| Outcome | Hyper-inflammatory | Non-hyper-inflammatory | P value |
|---|---|---|---|
| Ventilator-free days | 28 (IQR 23–28) | 28 (IQR 27–28) | P = 0.010 |
| ARDS, persistent hyper-inflammatory subphenotype (n = 22) vs others36.4% versus 10.4% | P = 0.003 |
- ARDS, persistent hyper-inflammatory subphenotype (n = 22) vs others — ARDS, persistent hyper-inflammatory
- 36.4%
- ARDS, persistent hyper-inflammatory subphenotype (n = 22) vs others — ARDS, others
- 10.4%
Subphenotype stability, day 1 and 4 (subgroup, n = 244)
- Remained in baseline class throughout day 4
- 77.9%
Original publication
Inflammatory subphenotypes in patients at risk of ARDS: evidence from the LIPS-A trial. Intensive Care Med. Published 31 October 2023. doi:10.
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