Physiology Is Vital to Precision Medicine in Acute Respiratory Distress Syndrome and Sepsis

Article Critical Care Medicine

A Research Agenda for Precision Medicine in Sepsis and Acute Respiratory Distress Syndrome An Official American Thoracic Society Research Statement

Faraaz Ali Shah et al.

Summary: Precision medicine focuses on identifying effective treatment strategies for groups of patients based on similar characteristics, and similar advances are possible in sepsis and ARDS with further research and investment. By creating knowledge networks, implementing novel trial designs, and continuing to innovate methods, precision medicine may offer better individualized therapies for patients.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2021)

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Article Critical Care Medicine

Effect of Lowering VT on Mortality in Acute Respiratory Distress Syndrome Varies with Respiratory System Elastance

Ewan C. Goligher et al.

Summary: The mortality benefit of ventilation with lower V-T in ARDS varies according to elastance, suggesting that lung-protective ventilation strategies should primarily target driving pressure rather than V-T.

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2021)

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Article Critical Care Medicine

Longitudinal respiratory subphenotypes in patients with COVID-19-related acute respiratory distress syndrome: results from three observational cohorts

Lieuwe D. J. Bos et al.

Summary: This study aimed to identify respiratory subphenotypes of COVID-19-related ARDS using data-driven approaches. While no consistent subphenotypes were identified at baseline, two distinct subphenotypes were found during the first 4 days of invasive mechanical ventilation. These subphenotypes demonstrated differences in patient outcomes, indicating the importance of subtyping in the progression and outcomes of ARDS patients.

LANCET RESPIRATORY MEDICINE (2021)

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Article Emergency Medicine

Non-invasive assessment of fluid responsiveness to guide fluid therapy in patients with sepsis in the emergency department: a prospective cohort study

Nienke K. Koopmans et al.

Summary: This study found that in patients with sepsis without shock, three out of four patients do not demonstrate a clinically relevant increase in CI after a standardised fluid challenge. Non-invasive cardiac output monitoring combined with a PLR test has the potential to identify patients who might benefit from fluid resuscitation and contribute to a better tailored treatment for these patients.

EMERGENCY MEDICINE JOURNAL (2021)

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Article Medicine, General & Internal

Therapeutic Anticoagulation with Heparin in Noncritically Ill Patients with Covid-19

Patrick R. Lawler et al.

Summary: This study showed that therapeutic-dose anticoagulation with heparin in non-critically ill patients with Covid-19 increased the likelihood of survival to hospital discharge and reduced the need for cardiovascular or respiratory organ support compared to usual-care thromboprophylaxis.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Critical Care Medicine