Citations 3
ARDS Subphenotypes as a Guide to Therapy and Enrollment into Therapeutic Trials: Not So Fast
Villar, Jesús , Szakmány, Tamás , Gajic, Ognjen, Casali, Diego , Cazorla-Rivero, Sara , Niven, Alexander S. , Niven, Alexander S , Gajic, Ognjen
Journal of Clinical Medicine | August 28, 2025 | Volume: 14 | Issue: 17 | Pages: 6088
Acute respiratory distress syndrome (ARDS) is a common and highly heterogeneous condition in the critically ill. The association between hyper- and hypo-inflammatory subphenotypes and clinical outcomes has generated significant interest in precise ARDS management. The value of identifying biomarkers to guide treatment and enrollment in future ARDS trials is undisputable. We describe multiple factors complicating the search for subphenotypes and their treatable traits. The observed heterogeneity seen in the clinical course of ARDS is dynamic and influenced by factors beyond lung pathophysiology, including variations in the delivery of best critical care practices, patient comorbidities, and functional status, and patient or family preferences. Current subphenotype definitions lack strong biological plausibility and without clear evidence of benefit from targeted treatments, their use in clinical practice is currently unwarranted.
Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries
Russotto, Vincenzo , Laffey, John G. , Tassistro, Elena , Camporota, Luigi , Higgs, A. , Putensen, Christian , Agvald‐Öhman, Christina, Bokums, Kristaps, Brewster, David , Rossi, Emanuela , Fumagalli, Roberto , Pesenti, Antonio, Investigators, INTUBE Study, Ahmed, Hazem , Adhikari, Neill K. J. , Agrawal, Kehari, Agrawal, Nipun , Aguirre-Bermeo, Hernán , Agvald-Öhman, Christina, Ahmad, Meraj, Ajami, Samareh, Akhtar, Shazia N., Alghamdi, Adnan, Alhadi, Abdulmueti , Ali, Syed Muhammad Adnan , Ali, Mohd N., Alias, Anita, Alonso, Julio, Montenegro, Diana Alvarez, Aman, Rubina, Anstey, Matthew , Αrnaoutoglou, Eleni , Baccari, Laura, Baliga, Nishanth, Manjunath, Ramya Ballekatte, Bamane, Shrirang, Bandert, Anna , Bartholdy, Roland, Baturova, Vera , Bellissima, Agrippino , Belsky, Vladislav, Bendre, Prashant, Benini, Annalisa, Besset, Sébastien , Bhattacharyya, Mahuya , Bielański, Piotr, Bigatello, Luca M., Boissier, Florence , Bonney, Iwona, Bowen, David , Boyer, Alexandre, Broman, Lina , Bruel, Cédric , Brunin, Yannick, Bugedo, Guillermo , Calamai, Italo , Campos, Patricia , Canavosio, Federico Giovanni , Cascella, Marco , Catorze, Nuno , Champigneulle, Benoît , Chandwani, Juhi, Chaurasia, Satish, Chawla, Rajesh , Chawla, Aakanksha, Cheetham, Olivia, Chemouni, Frank , Kiok, Lee Chew, Chimunda, Timothy , Chiu, Ching‐Tang , Chiumiento, Fernando, Chudeau, Nicolas , Colica, Sandra, Colin, Gwenhaël , Constantin, Jean‐Michel , Contou, Damien , Costa, Paulo F., Costa, Vasco , Cracchiolo, Andrea, Crone, Petra, Cunha, Rui Pedro, Radivojević, Renata Curić , Dash, Sampat, Pascale, Gennaro De , Torre, Valentina Della, Caprio, Barbara Di, Dimitropoulou, Aikaterini, Edmunds, Christopher , El-Fellah, Nadia, Elhadi, Ahmed , Escudero-Acha, P. , Espinoza, Missael, Esposito, Clelia, Fabretti, Fabrizio, Fein, Daniel , Ferluga, Massimo, Ferré, Alexis , Ferrier, Janet, Flaksa, Marek, Flores, Fernando , Gonzalez, Jesus Flores, Fuentes, Xavier Fonseca , Francis, Roland C. 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García, Garofalo, Eugenio , Gatward, Jonathan, Ghula, Mohamed , Giacomucci, Angelo , Giovannini, Ilaria , Gnanadurai, Kingsly Robert, Godet, Thomas, Fernandez, Gemma Goma , González, María del Carmen Martín, González, Daira, Gopalakrishna, Kadarapura Nanjundaiah , Gottesman, Eric , Gros, Alexandre, Gupta, Manish , Gupta, Kulbhusahn, Hamid, Tarikul , Hamzaoui, Olfa, Hannesdottir, Katrin, Hasan, Shahnaz, Hossain, Mozaffer, Hossein, Sazzad, Hraiech, Sami , Hypes, Cameron, Alkhumsi, Soad Imhmed R., Islam, Motiul, Ismail, Muhamad A., Ivančan, Višnja , Jacquier, Sophie , Jagiasi, Bharat, Jain, Nikhilesh , Jamaluddin, Muhamad Fadhil Hadi, Jeswani, Deepak , Jeswani, Deepti, Jha, Simant , Jones, Benjamin , Jozwiak, Mathieu , Jumić, Aleksandra, Kamp, Oliver , Karametos, Ilias, Karelov, Alexey, Kaufman, David A. , Kaushik, Shuchi, Kesavarapu, Subba R., Khaled, Ala , Khalidah, Hapiz, Khunteta, Sudhir , Kindgen‐Milles, Detlef , Korula, Sara , Kothekar, Amol , Koul, Salman S., Krog, Ditte, Kuellmar, Mira, Kuragayala, Swarna Deepak , Kyparissi, Aikaterini, Labarca, Gonzalo , Lalwani, Jaya, Landaverde, Antonio, Lehr, Andrew , Leonor, Tiago, Licciardi, A, Nava, Claudia L. Lopez, Gallardo, Luis R. Loza, Lungu, Ramona , Luzi, Annalisa, Ma, Wuhua , Μakris, Alexandros , Maheshwarappa, Harish Mallapura , Maraffi, Tommaso , Marcelli, Maria Elena, Mariano, Karim, Marin, Nathalie, Martin, Maëlle, Gonzalez, Mayra Martinez, Matas, Marijana , Matos, Dubier, Maugeri, Jessica Giuseppina , Mazlan, Mohd Zulfakar , Meersch, Melanie , Meher, Ranjan, Mehesry, Tasneem H., Meirik, Maria, Dessap, Armand Mekontso , Mensah, Kwabena , Mercier, Emmanuelle, Midya, Abhirup, Mihaljević, Slobodan , Mirouse, Adrien , Mishra, Prasanna K. , Mistry, Ravi , Moguš, Mate, Nordin, Norbaniza Mohd, Samat, Noryani Mohd, Montini, Luca, Moro, Valeria, Tutillo, Diego Morocho , Mrinal, Sircar, Mudyna, Wojciech, Munta, Kartik, Munusamy, Satheesh , Musso, Stefania, Muttini, Stefano , Irtiza, Ismail Nahla, Nakou, Evi, Narkhede, Amit , Nates, Joseph, Nespoli, M, Nespoli, Francesca, Nikitenko, Artem, Nogueira, Carla, O'Grady, Ross, Odeyemi, Yewande , Ohlsson, Annika , Orsello, Alberto, Palaniswamy, Vijayanand , Palma, Daniela Maria , Palmese, Salvatore , Leal, Jesus N. Pantoja, Papandreou, E., Papanikolaou, Metaxia, Patel, Mayur , Pavlek, Mario , Pedrotti, Niccolò , Hwa, Ngu Pei, Pelagalli, Lorella, Ruiz, Miryam Pérez, Persson, Elin, Petsiou, Athanasia, Philippard, Francois, Piegat, Mariusz, Pili‐Floury, Sébastien, Pinto, Márcia , Piton, Gaël , Plantefève, Gaëtan , Pouplet, Caroline, Pouriki, Sofia, Pradella, Andrea , Prashant, Kumar , Quayle, Alice, Rahmani, Lua S. , Randall, Ian , Ray, Banambar , Reza, Syed T., Ricard, Jean Damien, Riva, Ivano, Rona, Roberto , Rosell, Jon, Rowley, Rebecca, Rumschuessel, Kay, Rundo, Annalisa, Russo, Pierpaolo, Sahu, Samir, Salmon-Gandonnière, Charlotte, Roman, Nandyelly San Juan, Sandefur, Benjamin J. , Santoro, Lida, Sanyal, Rhik, Saravanabavan, Lakshmikanthcharan , Shah, Bhagyesh, Shah, Mehul , Shin, Ming-Hann, Simpson, Shannon, Sinah, Ayush, Singh, D. K., Singh, Nitesh , Singh, Lalit, Skowronski, Lukasz , Sosa, Miguel A. Gama , Spadaro, Savino , Spångfors, Martin , Sperber, Jesper , Spina, Rosario, Srivastava, Anand , Steel, Andrew, Suárez-de-la-Rica, Alejandro , Kumar, Singh Sujeet, Sundrani, Omprakash, Sunil, Nilu, Suparna, Bharadwaj, Surath, Manimala R., Syed, Yadullah, Sztrymf, Benjamin , Tarantino, Stefano, Tileli, Maria, Castro, Hugo Arturo Tirapé , Toledo-Salinas, Otoniel , Tramarin, Jacopo, Tsiftsis, D , Tucić, Iva , León, Jose A. Tutillo, Tutino, Lorenzo, Tyagi, Vijay, Vagdatli, Kyriaki, Varkey, Sneha, Vera, Magdalena , Seth, Magnus Von, Wahlström, C.-G., Ismail, Wan Nasrudin Wan, Winiszewski, Hadrien , Wu, Lun , Zani, Gianluca , Zarka, Jonathan , Zhao, Dawn, Zlotnik, Diane , Bauer, Philippe, Laffey, John G , Labarca, Gonzalo , Alhadi, Abdulmueti , Myatra, Sheila Nainan , Antolini, Laura , Bauer, Philippe R. , Lascarrou, Jean-Baptiste , Szuldrzynski, Konstanty S. , Pelosi, Paolo , Sorbello, Massimiliano , Greif, Robert , Chalkias, Athanasios F. , Pesenti, Antonio, Foti, Giuseppe , Bellani, Giacomo , Investigators, INTUBE Study, Agvald-Öhman, Christina, Ahmad, Meraj, Almekhlafi, Ghaleb A. , Aragão, Irene , Azoulay, Élie , Basto, Marta Lima , Besset, Sebastien, Boni, Elisa, Brazzi, Luca , Broman, Lina, Browne, Alexander, Cappellini, Iacopo , Chao, Anne , Chien, Jung‐Yien , Chou, Nai‐Kuan , Cortegiani, Andrea , Costamagna, Andrea , Cotoia, Antonella , Cracchiolo, Andrea N., Das, Amit, Rosa, Silvia De , Sorbo, Lorenzo Del , Fenza, Raffaele Di , Giacinto, Ida Di , Dudda, Marcel , Ehrentraut, Stefan , Elhadi, Muhammed , Fernandes, Marco, Flores, Fernando, Frat, Jean-Pierre , Fusari, Maurizio , Moraes, Alice Gallo de , Gammaldi, Renato , Gaszynski, Tomasz M , Godet, Thomas , Goffi, Alberto , González-Castro, A. , Guervilly, Christophe , Guitton, Christophe , Huang, Chun‐Kai , Jankowski, Miłosz , Jones, Laura, Karelov, Alexey, Katsoulis, P. , Kaye, Callum T. , Khalidah, Hapiz, Khan, Akram , Ku, Shih‐Chi , Kuo, Lu-Cheng , Lalwani, Jaya, Laserna, Andrés , Lee, Chien‐Chang , Legriel, Stéphane , Li, Yongxing , Licciardi, Anna Lisa, Litton, Edward , Ломиворотов, В. 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JAMA | March 23, 2021 | Volume: 325 | Issue: 12 | Pages: 1164
Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome. Insights from the LUNG SAFE Study
Laffey, John G. , Pham, Tài , Madotto, Fabiana , Brochard, Laurent , Esteban, Andres, Gattinoni, Luciano , Bumbaširević, Vesna, Piquilloud, Lise , Haren, Frank van , Larsson, Anders, McAuley, Daniel F. , Arabi, Yaseen M. , Ranieri, Marco, Antonelli, Massimo , Rubenfeld, Gordon D., Wrigge, Hermann , Slutsky, Arthur S. , Schultz, Marcus J. , Bajwa, Ednan K. , Ferguson, Niall D. , Frendl, György , Brown, Samuel M. , Terzi, Nicolas , Brazzi, Luca , Montini, Luca , Tomescu, Dana , Lanspa, Michael J. , Almekhlafi, Ghaleb A. , Cortegiani, Andrea , Fusari, Maurizio , González-Castro, A. , Parotto, Matteo , Sánchez‐Hurtado, Luis Alejandro , Spadaro, Savino , Szakmány, Tamás , Zani, Gianluca , Bihari, Shailesh , Laffey, John G , Bellani, Giacomo , Fan, Eddy , Esteban, Andres, Bauer, Philippe R. , Thompson, Bruce , Pesenti, Antonio Maria , Schultz, Marcus J , Arabi, Yaseen M
American Journal of Respiratory and Critical Care Medicine | October 18, 2016 | Volume: 195 | Issue: 1 | Pages: 67-77
Abstract Rationale Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use in patients with ARDS remains relatively sparse. Objectives To determine whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful. Methods The LUNG SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) study described the management of patients with ARDS. This substudy examines the current practice of NIV use in ARDS, the utility of the PaO2/FiO2 ratio in classifying patients receiving NIV, and the impact of NIV on outcome. Measurements and Main Results Of 2,813 patients with ARDS, 436 (15.5%) were managed with NIV on Days 1 and 2 following fulfillment of diagnostic criteria. Classification of ARDS severity based on PaO2/FiO2 ratio was associated with an increase in intensity of ventilatory support, NIV failure, and intensive care unit (ICU) mortality. NIV failure occurred in 22.2% of mild, 42.3% of moderate, and 47.1% of patients with severe ARDS. Hospital mortality in patients with NIV success and failure was 16.1% and 45.4%, respectively. NIV use was independently associated with increased ICU (hazard ratio, 1.446 [95% confidence interval, 1.159–1.805]), but not hospital, mortality. In a propensity matched analysis, ICU mortality was higher in NIV than invasively ventilated patients with a PaO2/FiO2 lower than 150 mm Hg. Conclusions NIV was used in 15% of patients with ARDS, irrespective of severity category. NIV seems to be associated with higher ICU mortality in patients with a PaO2/FiO2 lower than 150 mm Hg. Clinical trial registered with www.clinicaltrials.gov (NCT 02010073).