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ORIGINAL RESEARCH article

Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1476512
This article is part of the Research Topic Personalized Therapy in ARDS - Volume II View all 7 articles

Subphenotypic features of patients with sepsis and ARDS : A Multicenter Cohorts Study

Provisionally accepted
Nan Li Nan Li 1Ge Feng Ge Feng 2*Lin Zhang Lin Zhang 2*Ying Liu Ying Liu 1*Hongxu Jin Hongxu Jin 1Hao shen Hao shen 3*Keliang XIE Keliang XIE 4*Yan Gao Yan Gao 1*
  • 1 Northern Theater Command General Hospital, Shenyang, Liaoning Province, China
  • 2 Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
  • 3 Tianjin Beichen Hospital, Tianjin, China
  • 4 Tianjin Medical University, Tianjin, China

The final, formatted version of the article will be published soon.

    Patients with sepsis are often comorbid with Acute Respiratory Distress Syndrome (ARDS), and the phenotypic characteristics of pulmonary and non-pulmonary infections leading to ARDS are still unclear.The aim of this study was to compare the phenotypic characteristics of ARDS resulting from pulmonary infections and other non-site infections and better guidance for clinical treatment.Methods:We conducted a multicenter cohorts analysis using data from the Tianjin Medical University General Hospital, Medical Information Mart for Intensive Care IV (MIMIC IV) and the electronic Intensive Care Unit (eICU) databases. The study population consisted of adult patients diagnosed with sepsis and ARDS. The primary objectives were to compare the characteristics and outcomes of patients with pulmonary infection and non-pulmonary infection induced ARDS by Wilcoxon, Kaplan-Meier curve, correlation analysis, propensity matching score and other methods.Results: Patients with ARDS by pulmonary infection may be more likely to have a history of chronic obstructive pulmonary disease, and abdominal infection was more likely to induced to ARDS in sepsis patients with non-pulmonary infection. Pulmonary infections caused by Klebsiella pneumoniae and Acinetobacter baumannii were more likely to induced ARDS. The oxygenation index and prognosis of ARDS patients induced by pulmonary infection were worse than those caused by other infections, with lower PaO2, PaO2/FiO2, and ROX index, longer hospital stay, more ARDS patients with pulmonary infection were given mechanical ventilation therapy, higher mortality, higher APACHE II, SOFA, SAPS II. The further correlation analysis showed that the prognostic scores of ARDS patients were negatively correlated with PaO2/FiO2 and ROX index. The above results were confirmed to varying degrees by propensity matching scores, external cohort validation and other methods.Conclusions: Pulmonary infection induces worse prognosis of ARDS than other site infections in patients with sepsis and ARDS. These patients require heightened vigilance, early intervention, and possibly more aggressive 3 management strategies.

    Keywords: Sepsis, Acute respiratory distress syndrome (ARDS), pulmonary infections, Non-pulmonary Infections, Subphenotypic

    Received: 05 Aug 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 Li, Feng, Zhang, Liu, Jin, shen, XIE and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Ge Feng, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
    Lin Zhang, Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
    Ying Liu, Northern Theater Command General Hospital, Shenyang, 110017, Liaoning Province, China
    Hao shen, Tianjin Beichen Hospital, Tianjin, China
    Keliang XIE, Tianjin Medical University, Tianjin, China
    Yan Gao, Northern Theater Command General Hospital, Shenyang, 110017, Liaoning Province, China

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