Respiratory failure & ventilation
Temporal stability of inflammatory subphenotypes of acute respiratory distress syndrome: 28-day insights from the ICAR trial
Authors' conclusion
Inflammatory subphenotypes were stable in COVID-19-related ARDS, with few transitions over 28 days.
Study context
- Population
- Patients with COVID-19-related moderate-to-severe acute respiratory distress syndrome (ARDS), 43 centres
- Participants
- 146 patients · 43 centres
- Comparison
- Hyperinflammatory vs hypoinflammatory ARDS subphenotype
- Hyperinflammatoryn = 25
- Hypoinflammatoryn = 121reference
- Primary endpoint
- Temporal stability of ARDS subphenotypes (transitions over 7-day intervals)
- Follow-up
- 28 days
Methodological detailsmulticentre, K-means clustering, Bayesian discrete-time Markov model
- Multicentre
- K-means clustering
- Bayesian discrete-time Markov model
Primary result
As reported in the abstract
Transition probabilities over 7-day intervals (Bayesian Markov model)
Extubated
| Outcome | Hypoinflammatory | Hyperinflammatory |
|---|---|---|
| Remaining hypoinflammatory | 70% | — not stated in the abstract |
| Progressing to hyperinflammatory | 7% | — not stated in the abstract |
| Remaining hyperinflammatory | — not stated in the abstract | 52% |
| Dying | — not stated in the abstract | 23% |
| Transitioning to hypoinflammatory | — not stated in the abstract | 20% |
— not stated in the abstract
Further findings
28-day mortality
P = 0.001
| Outcome | P value |
|---|---|
| Ventilator-free days through day 28Fewer in hyperinflammatory | P < 0.01 |
Organ failure, plasma biomarkers, endothelial stability
- Hyperinflammatory: higher organ failure rates, higher cytokines, chemokines, adhesion molecules and proangiogenic factors, lower endothelial stability vs hypoinflammatory
Original publication
Temporal stability of inflammatory subphenotypes of acute respiratory distress syndrome: 28-day insights from the ICAR trial. Anaesth Crit Care Pain Med. Published 26 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →