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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 12/2020

18.11.2020 | COVID-19 | Review Zur Zeit gratis

Phenotypes and personalized medicine in the acute respiratory distress syndrome

verfasst von: Michael A. Matthay, Yaseen M. Arabi, Emily R. Siegel, Lorraine B. Ware, Lieuwe D. J. Bos, Pratik Sinha, Jeremy R. Beitler, Katherine D. Wick, Martha A. Q. Curley, Jean-Michel Constantin, Joseph E. Levitt, Carolyn S. Calfee

Erschienen in: Intensive Care Medicine | Ausgabe 12/2020

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Abstract

Although the acute respiratory distress syndrome (ARDS) is well defined by the development of acute hypoxemia, bilateral infiltrates and non-cardiogenic pulmonary edema, ARDS is heterogeneous in terms of clinical risk factors, physiology of lung injury, microbiology, and biology, potentially explaining why pharmacologic therapies have been mostly unsuccessful in treating ARDS. Identifying phenotypes of ARDS and integrating this information into patient selection for clinical trials may increase the chance for efficacy with new treatments. In this review, we focus on classifying ARDS by the associated clinical disorders, physiological data, and radiographic imaging. We consider biologic phenotypes, including plasma protein biomarkers, gene expression, and common causative microbiologic pathogens. We will also discuss the issue of focusing clinical trials on the patient’s phase of lung injury, including prevention, administration of therapy during early acute lung injury, and treatment of established ARDS. A more in depth understanding of the interplay of these variables in ARDS should provide more success in designing and conducting clinical trials and achieving the goal of personalized medicine.
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Metadaten
Titel
Phenotypes and personalized medicine in the acute respiratory distress syndrome
verfasst von
Michael A. Matthay
Yaseen M. Arabi
Emily R. Siegel
Lorraine B. Ware
Lieuwe D. J. Bos
Pratik Sinha
Jeremy R. Beitler
Katherine D. Wick
Martha A. Q. Curley
Jean-Michel Constantin
Joseph E. Levitt
Carolyn S. Calfee
Publikationsdatum
18.11.2020
Verlag
Springer Berlin Heidelberg
Schlagwort
COVID-19
Erschienen in
Intensive Care Medicine / Ausgabe 12/2020
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-020-06296-9

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