ARDS - The "Real" Definition by Gordon Rubenfeld, MD M.Sc for OPENPediatrics

Explore the complexities of Acute Respiratory Distress Syndrome (ARDS) in this 27-minute lecture by Dr. Gordon Rubenfeld for OPENPediatrics. Delve into the historical context of ARDS, tracing its clinical phenotype back to 1967, and examine the challenges in defining and diagnosing this condition without a specific biomarker. Learn about the Berlin Definition, its impact on literature, and recent developments in ARDS research. Analyze the importance of clinical syndromes in medicine, the reliability and validity of ARDS definitions, and the potential differences between direct and indirect ARDS. Gain insights into novel patient-level meta-analyses and the use of latent class modeling for identifying ARDS subphenotypes, providing a comprehensive overview of current understanding and future directions in ARDS research and clinical practice.

Intro
Outline
Everything we know about the ARDS clinical phenotype we learned in 1967
Syndromes are common in medicine and critical care
AECC definition Reliability and confusion
Everyone agrees we need a better ARDS definition but, what does better mean? • Reliability, Validity, Feasibility • How do you study validity without a gold standard?
Are direct (pulmonary) and indirect (extra-pulmonary) ARDS different?
Potential impact of recent changes in the definition of ARDS for clinical research
Berlin Draft Definition
Novel patient-level meta-analysis of 7 cohorts: 4 Clinical and 3 Physiological
Evaluation of Severe Ancilary variables identify a smaller group of patients with similar mortality 45% Mortality
A way forward - smarter biology latent class modeling for subphenotypes