Plasma sRAGE Level May Predict Response to Lung Recruitment in ARDS

This secondary analysis of the LIVE trial examined whether baseline plasma sRAGE (an epithelial injury biomarker) or inflammatory phenotype could identify differential treatment effects of lung recruitment versus low-PEEP strategies on 90-day mortality in 259 ARDS patients. The study reported that high sRAGE patients had lower mortality with lung recruitment (HR 0.41) while low sRAGE patients had higher mortality with this strategy (HR 3.27), whereas inflammatory phenotype did not identify this treatment heterogeneity despite being associated with mortality overall. The authors state that epithelial injury markers, but not inflammatory phenotypes, may help identify which ARDS patients respond differently to lung recruitment.

Most relevant for: Patients with ARDS being considered for lung recruitment versus low-PEEP ventilation strategies, particularly in distinguishing focal from non-focal disease.

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