Precision Medicine and Heterogeneity of Treatment Effect in Therapies for ARDS

被引：37

作者：

Khan, Yasin A. ^{[1
,2
,3
]}

Fan, Eddy ^{[1
,2
,3
,5
,6
]}

Ferguson, Niall D. ^{[1
,2
,3
,4
,5
,6
]}

机构：

[1] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada

[2] Univ Toronto, Dept Med, Toronto, ON, Canada

[3] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[4] Univ Toronto, Dept Physiol, Toronto, ON, Canada

[5] Toronto Gen Hosp, Res Inst, Toronto, ON, Canada

[6] Univ Hlth Network, Div Respirol, Dept Med, Toronto, ON, Canada

来源：

CHEST | 2021年 / 160卷 / 05期

关键词：

acute respiratory failure; ARDS; heterogeneity of treatment effect; RESPIRATORY-DISTRESS-SYNDROME; END-EXPIRATORY PRESSURE; ACUTE LUNG INJURY; HIGH-FREQUENCY OSCILLATION; TIDAL VOLUME VENTILATION; CLINICAL-TRIALS; PROTECTIVE-VENTILATION; DRIVING PRESSURE; MORTALITY; RECRUITMENT;

D O I：

10.1016/j.chest.2021.07.009

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

ARDS is a clinically heterogeneous syndrome, rather than a distinct disease. This heterogeneity at least partially explains the difficulty in studying treatments for these patients and contributes to the numerous trials of therapies for the syndrome that have not shown benefit. Recent studies have identified different subphenotypes within the heterogeneous patient population. These different subphenotypes likely have variable clinical responses to specific therapies, a concept known as heterogeneity of treatment effect. Recognizing different subphenotypes and heterogeneity of treatment effect has important implications for the clinical management of patients with ARDS. This review presents studies that have identified different subphenotypes and discusses how they can modify the effects of therapies evaluated in trials that are commonly considered to have shown no overall benefit in patients with ARDS. CHEST 2021; 160(5):1729-1738

引用

页码：1729 / 1738

页数：10

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