Precision Pharmacotherapy in ARDS: Matching Biology to Treatment
A narrative review arguing that ARDS drug failures reflect biological heterogeneity, not therapeutic futility, with direct implications for how ICU pharmacists interpret and apply immunomodulatory and anticoagulant trials.
ARDScorticosteroidsdexamethasonemethylprednisoloneanakinratocilizumabheparinthrombomodulinprecision medicinesubphenotypesendotypestreatable traitscritical carenarrative reviewimmunomodulationCritical Care / ICU
Background Information
Precision ARDS therapies hinge on biomarker-driven stratification.
Acute respiratory distress syndrome (ARDS) causes significant morbidity and mortality, and current treatments do not address its biological heterogeneity. The review identifies biological subphenotypes in ARDS, such as hyperinflammatory states, that indicate different treatment responses, with emphasis on targeted therapies like anticoagulants. Recognizing ARDS as a biologically diverse syndrome may help develop more effective, tailored treatment strategies, although challenges like biomarker validation remain. ARDS treatment should consider biological and temporal patient differences for improved outcomes.
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Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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