TY - JOUR
T1 - Understanding clinical and biological heterogeneity to advance precision medicine in paediatric acute respiratory distress syndrome
AU - Kneyber, Martin C.J.
AU - Khemani, Robinder G.
AU - Bhalla, Anoopindar
AU - Blokpoel, Robert G.T.
AU - Cruces, Pablo
AU - Dahmer, Mary K.
AU - Emeriaud, Guillaume
AU - Grunwell, Jocelyn
AU - Ilia, Stavroula
AU - Katira, Bhushan H.
AU - Lopez-Fernandez, Yolanda M.
AU - Rajapreyar, Prakadeshwari
AU - Sanchez-Pinto, L. Nelson
AU - Rimensberger, Peter C.
N1 - Copyright © 2023 Elsevier Ltd. All rights reserved.
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Paediatric acute respiratory distress syndrome (PARDS) is a heterogeneous clinical syndrome that is associated with high rates of mortality and long-term morbidity. Factors that distinguish PARDS from adult acute respiratory distress syndrome (ARDS) include changes in developmental stage and lung maturation with age, precipitating factors, and comorbidities. No specific treatment is available for PARDS and management is largely supportive, but methods to identify patients who would benefit from specific ventilation strategies or ancillary treatments, such as prone positioning, are needed. Understanding of the clinical and biological heterogeneity of PARDS, and of differences in clinical features and clinical course, pathobiology, response to treatment, and outcomes between PARDS and adult ARDS, will be key to the development of novel preventive and therapeutic strategies and a precision medicine approach to care. Studies in which clinical, biomarker, and transcriptomic data, as well as informatics, are used to unpack the biological and phenotypic heterogeneity of PARDS, and implementation of methods to better identify patients with PARDS, including methods to rapidly identify subphenotypes and endotypes at the point of care, will drive progress on the path to precision medicine.
AB - Paediatric acute respiratory distress syndrome (PARDS) is a heterogeneous clinical syndrome that is associated with high rates of mortality and long-term morbidity. Factors that distinguish PARDS from adult acute respiratory distress syndrome (ARDS) include changes in developmental stage and lung maturation with age, precipitating factors, and comorbidities. No specific treatment is available for PARDS and management is largely supportive, but methods to identify patients who would benefit from specific ventilation strategies or ancillary treatments, such as prone positioning, are needed. Understanding of the clinical and biological heterogeneity of PARDS, and of differences in clinical features and clinical course, pathobiology, response to treatment, and outcomes between PARDS and adult ARDS, will be key to the development of novel preventive and therapeutic strategies and a precision medicine approach to care. Studies in which clinical, biomarker, and transcriptomic data, as well as informatics, are used to unpack the biological and phenotypic heterogeneity of PARDS, and implementation of methods to better identify patients with PARDS, including methods to rapidly identify subphenotypes and endotypes at the point of care, will drive progress on the path to precision medicine.
KW - Biomarkers
KW - Child
KW - Humans
KW - Lung
KW - Precision Medicine
KW - Respiratory Distress Syndrome/therapy
UR - http://www.scopus.com/inward/record.url?scp=85147389836&partnerID=8YFLogxK
U2 - 10.1016/S2213-2600(22)00483-0
DO - 10.1016/S2213-2600(22)00483-0
M3 - Review article
C2 - 36566767
AN - SCOPUS:85147389836
SN - 2213-2600
VL - 11
SP - 197
EP - 212
JO - The Lancet. Respiratory medicine
JF - The Lancet. Respiratory medicine
IS - 2
ER -