Respiratory failure & ventilation
Subphenotypes in patients with acute respiratory distress syndrome treated with high-flow oxygen
Authors' conclusion
ARDS patients treated with HFNO exhibit two biological subphenotypes that have similar clinical characteristics, but hyperinflammatory patients have worse outcomes.
Study context
- Population
- Acute respiratory distress syndrome (ARDS) patients supported with high-flow nasal oxygen (HFNO)
- Participants
- 41 patients
- Comparison
- Hyperinflammatory vs hypoinflammatory subphenotype
- Hyperinflammatoryn = 17
- Hypoinflammatoryn = 24reference
- Primary endpoint
- Biological subphenotypes (K-means cluster analysis of plasma biomarkers and bicarbonate)
Methodological detailsK-means cluster analysis
- K-means cluster analysis
Primary result
As reported in the abstract
Subphenotypes identified
- Two subphenotypes identified; hyperinflammatory showed higher biomarker levels than hypoinflammatory, with similar baseline characteristics
Further findings
Mortality · 60-day
P = 0.014
| Outcome | Hyperinflammatory | Hypoinflammatory | P value |
|---|---|---|---|
| ICU LOS | 22.0 (range 18.0–30.0) days | 39.5 (range 25.5–60.0) | P = 0.034 |
- ICU LOS: described as longer in hyperinflammatory although printed values are lower
HAIS score (IL-8 and sST2) distinguishing subphenotypes
- AUROC
- 0.96 (95%CI: 0.90-1.00)
- HAIS score ≥ 7.45 predictor of hyperinflammatory subphenotype
Original publication
Subphenotypes in patients with acute respiratory distress syndrome treated with high-flow oxygen. Crit Care. Published 1 November 2023. doi:10.
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