Stratified interventions in ARDS: EMINENT ARDS Work Package 2.

急性呼吸窘迫综合征(ARDS)是一种严重的急性呼吸衰竭，全世界10%的重症监护病房患者都会受到影响。虽然住院死亡率仍然很高(35%-46%)，但70%的长期幸存者随后恢复了患病前的工作，这表明有很大的康复潜力。世界上任何地方都没有获得许可的ARDS药物治疗，我们对ARDS疾病过程的了解仍然有限。此外，ARDS患者群体中存在相当大的异质性。这些因素加在一起，是药物发现的主要障碍。我们迫切需要进一步定义ARDS的疾病机制，并开发工具来帮助患者分层，以便我们能够确保正确的患者在正确的时间接受正确的药物。在确定了第一工作包(WP1)中的ARDS患者的多个新亚组后，我们现在希望前瞻性地验证这些亚组在新的ARDS患者群体中的存在，并确定我们确定的这些组是否在机械上是离散的，或者它们是否代表同一病理的不同阶段，以及确定我们发现的亚组是否适合进行治疗干预。

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.