Thread by @teddyhla

Carolyn Calfee Clinical and Biological phenotypes of ARDS
- what do they have in common?

ARDS : subgrouping since the begining
- sepsis vs. non sepsis
- hyper vs. hypoinflamm
- reactive vs uninflamed
#ventilation #ards #phenotypes #LIVES2022

Are clinical phenotypes biologically distinct?
looking at Trauma vs. Non trauma

ICAM-1 , SP-D, vWF, sTNFr-1 are different.
What about in "Direct" vs. "indirect"
or "Diffuse" vs "focal" -- sRAGE comes up again.

pubmed.ncbi.nlm.nih.gov/17944012/
#ventilation #ARDS #LIVES2022

Citing earlier Bos article of plasma biomarkers used in cluster analysis.
- interestingly these biomarker identification matches with mechanically ventilated patients.
atsjournals.org/doi/10.1164/rc…

Now, what about we look at distinct phenotypes clinical or biological

Using Latent Class Phenotypes

- "hyper-inflam" phenotype consistently worse outcomes
- latent phenotypes appear to respond differently.
- you can see the nice sepeartion of those latent classes here >

What about we can use data driven phenotype in COVID. whether these will overlap with pre covid.

it fits.

pubmed.ncbi.nlm.nih.gov/34543591/

Nice separation to two classes

See the matching from pre covid and covid patients

The key difference is their "differential response" to steroids.

At this moment, this is nothing more than retrospective generation. But these groups and differential effects to steroids signal is strong.

a lot of debate about " whether we should use clinical or biochemical data". it is all about what question you are asking.

and future vision : redefining critical illness using multi-omic , multi-soruce parameters.

pubmed.ncbi.nlm.nih.gov/35715504/

This is sooo amazing

Absolutely mind blowing

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