Acute Respiratory Distress Syndrome (ARDS): Personalized Therapies and Beyond, 2nd Edition

Topic Information

Dear Colleagues,

Acute respiratory distress syndrome (ARDS), which is characterized by severe inflammation and impaired gas exchange, presents a serious issue in critical care. Although supportive care has advanced, death rates are still high, highlighting the critical need for individualized treatment plans. The goal of this multidisciplinary topic is to examine novel strategies for managing ARDS, with a focus on the significance of customizing therapies to each patient's unique profile. Among the many subjects covered by the contributions are the use of sophisticated imaging methods to track lung function, the significance of genomes and biomarkers in forecasting treatment response, and the use of machine learning algorithms in therapeutic decision-making. Furthermore, new pharmaceuticals and supplemental therapy including immunomodulatory therapies and extracorporeal membrane oxygenation (ECMO) will be discussed. This Topic aims to shed light on the route to more efficient, individualized treatment for ARDS patients, eventually leading to better outcomes and an improvement in quality of life, by encouraging multidisciplinary collaboration and exchanging state-of-the-art research. Pre-clinical experimentation, clinical studies, reviews, and perspectives are all welcome for submission.

Dr. Denise Battaglini
Prof. Dr. Patricia Rieken Macêdo Rocco
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Biomedicines biomedicines	3.9	6.8	2013	21 Days	CHF 2600
Clinics and Practice clinpract	2.2	2.8	2011	25.7 Days	CHF 1800
Diseases diseases	3.0	3.7	2013	21 Days	CHF 1800
Journal of Clinical Medicine jcm	2.9	5.2	2012	18.5 Days	CHF 2600
Pathophysiology pathophysiology	2.6	4.6	1994	27.8 Days	CHF 1500
Therapeutics therapeutics	-	-	2024	15.0 days *	CHF 1000

* Median value for all MDPI journals in the second half of 2025.

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Published Papers (3 papers)

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All Clinics and Practice JCM Therapeutics Diseases Pathophysiology Biomedicines

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10 pages, 791 KB  

Open AccessArticle

Acute Respiratory Distress Syndrome in Patients with Intracerebral Hemorrhage

by Thomas Christianson, Terry Nowell, Jay B. Lusk, Anna C. Covington, Wenjing Qi, Jordan Komisarow, Nazish Hashimi, Shreyansh Shah, Vijay Krishnamoorthy, Yisi Ng and Michael L. James

J. Clin. Med. 2026, 15(1), 205; https://doi.org/10.3390/jcm15010205 - 26 Dec 2025

Viewed by 701

Abstract

Introduction: Patients with an intracerebral hemorrhage (ICH) have been shown to have a high incidence of acute respiratory distress syndrome (ARDS). We aimed to determine the incidence of ARDS following ICH in the era of lung-protective ventilation. We also examined risk factors [...] Read more.

Introduction: Patients with an intracerebral hemorrhage (ICH) have been shown to have a high incidence of acute respiratory distress syndrome (ARDS). We aimed to determine the incidence of ARDS following ICH in the era of lung-protective ventilation. We also examined risk factors associated with ARDS following ICH. Materials and Methods: A retrospective cohort study of adults admitted to a single health system’s intensive care units with acute, spontaneous ICH from 1 March 2015 to 28 February 2018, using univariate and multivariable logistic regression models to evaluate the associations of patient characteristics with the diagnosis of ARDS. Results: In total, 269 patients were included, with 155 patients requiring invasive mechanical ventilation. The overall incidence of ARDS was 6.7% (18/269), and the incidence in intubated patients was 10% (16/155), as the median time of ventilation with >8 cc/mL of ideal body weight was low. For the entire ICH population, severity of hypoxemia on initial arterial blood gas (ABG; Odds Ratio [OR] per 10 mmHg 0.855 [95% Confidence Interval [CI] 0.74–0.987]) and total minutes of mechanical ventilation (OR per 60 min 1.018 [95% CI 1.007–1.029]) were both associated with the diagnosis of ARDS. In intubated patients, ventilation, younger age (OR per 10 years 0.655 [95% CI 0.431–0.997]), and total minutes of mechanical ventilation (OR per 60 min 1.028 [95% CI 1.006–1.049] increased the odds of developing ARDS. Conclusions: ARDS was found to be significantly lower in the present cohort of ICH patients when compared to prior studies, with younger age and hypoxemia associated with an increasing risk. Full article

(This article belongs to the Topic Acute Respiratory Distress Syndrome (ARDS): Personalized Therapies and Beyond, 2nd Edition)

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25 pages, 866 KB  

Open AccessReview

Ventilator-Induced Lung Injury: The Unseen Challenge in Acute Respiratory Distress Syndrome Management

by Raffaele Merola, Maria Vargas and Denise Battaglini

J. Clin. Med. 2025, 14(11), 3910; https://doi.org/10.3390/jcm14113910 - 2 Jun 2025

Cited by 14 | Viewed by 9287

Abstract

Invasive mechanical ventilation is a cornerstone therapy for supporting patients with acute respiratory distress syndrome (ARDS) by relieving respiratory muscle strain and ensuring gas exchange. Despite its life-saving benefits, mechanical ventilation can induce ventilator-induced lung injury (VILI), a critical condition characterized by mechanisms [...] Read more.

Invasive mechanical ventilation is a cornerstone therapy for supporting patients with acute respiratory distress syndrome (ARDS) by relieving respiratory muscle strain and ensuring gas exchange. Despite its life-saving benefits, mechanical ventilation can induce ventilator-induced lung injury (VILI), a critical condition characterized by mechanisms such as barotrauma, volutrauma, atelectrauma, ergotrauma, and biotrauma. This review examines the pathophysiological mechanisms of VILI and their impact on lung function, particularly in patients with ARDS. It highlights the importance of lung-protective ventilation strategies, including low tidal volume and tailored positive end-expiratory pressure, which have been shown to improve outcomes in ARDS. The role of prone positioning in enhancing lung homogeneity and improving outcomes is also discussed. Furthermore, emerging concepts such as mechanical power and individual respiratory mechanics are explored as potential avenues for personalized ventilation strategies. Despite advancements, the optimal approach to mechanical ventilation remains a subject of ongoing research. Full article

(This article belongs to the Topic Acute Respiratory Distress Syndrome (ARDS): Personalized Therapies and Beyond, 2nd Edition)

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12 pages, 1384 KB  

Open AccessArticle

Comparison of COVID-19 and Non-COVID-19 Tracheostomised Patients: Complications, Survival, and Mortality Risk Factors

by Marta Mesalles-Ruiz, Maitane Alonso, Marc Cruellas, Martí Plana, Anna Penella, Alejandro Portillo, Víctor Daniel Gumucio, Xavier González-Compta, Manel Mañós and Julio Nogués

J. Clin. Med. 2025, 14(2), 633; https://doi.org/10.3390/jcm14020633 - 19 Jan 2025

Cited by 1 | Viewed by 1589

Abstract

Objectives: To compare the outcomes of tracheostomised COVID-19 patients with non-COVID-19 tracheostomised patients to identify factors influencing severity and mortality. Methods: A retrospective, single-centre cohort study was conducted on COVID-19 tracheostomised patients admitted from May 2020 to February 2022, compared with a cohort [...] Read more.

Objectives: To compare the outcomes of tracheostomised COVID-19 patients with non-COVID-19 tracheostomised patients to identify factors influencing severity and mortality. Methods: A retrospective, single-centre cohort study was conducted on COVID-19 tracheostomised patients admitted from May 2020 to February 2022, compared with a cohort of non-COVID-19 tracheostomised patients. Results: COVID-19 tracheostomised patients had a higher mortality rate (50% vs. 27.3% in non-COVID-19 patients). Mortality risk factors in COVID-19 tracheostomised patients included female sex (HR 1.99, CI 1.09–3.61, p = 0.025), ischemic heart disease (HR 5.71, CI 1.59–20.53, p = 0.008), elevated pre-tracheostomy values of PEEP (HR 1.06, CI 1.01–1.11, p = 0.017) and INR (HR 1.04, CI 1.01–1.07, p = 0.004), and ventilatory complications (HR 8.63, CI 1.09–68.26, p = 0.041). No significant differences in complication rates were found based on Sars-CoV-2 infection or tracheostomy type. Conclusions: Tracheostomy technique did not impact complications, discharge circumstances, or mortality, supporting the safety of bedside percutaneous tracheostomies for COVID-19 patients. COVID-19 tracheostomised patients exhibited a higher mortality rate. Full article

(This article belongs to the Topic Acute Respiratory Distress Syndrome (ARDS): Personalized Therapies and Beyond, 2nd Edition)

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