Stratified interventions in ARDS: EMINENT ARDS Work Package 2.

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Acute respiratory distress syndrome (ARDS) is a severe form of acute respiratory failure that affects >10% of all patients admitted to intensive care units across the world. Although in-hospital mortality remains high (35-46%), 70% of long-term survivors subsequently return to their pre-morbid employment, indicating significant potential for recovery. There is no licensed pharmacotherapy for ARDS anywhere in the world, and our understanding of ARDS disease processes remains limited. Moreover, considerable heterogeneity exists within the population of patients with ARDS. Together these factors represent a major roadblock to drug discovery. There is an urgent and unmet need to further define disease mechanisms in ARDS, and to develop tools to aid patient stratification so we can ensure the right drug is received by the right patient at the right time.Having identified multiple novel subgroups of patients with ARDS in Work Package One (WP1), we now wish to prospectively validate the presence of these groups in a new population of patients with ARDS, and determine whether the groups we identified are mechanistically discrete, or whether they represent different phases of the same pathology, as well as to determine whether the subgroups we found may be amenable to therapeutic intervention.