Subphenotypes in critical care: translation into clinical practice

Kiran Reddy, Pratik Sinha, Cecilia O'Kane, Anthony Gordon, Carolyn S Calfee, Danny McAuley

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)
310 Downloads (Pure)


Despite progress in the supportive care available for critically ill patients, few advances have been made in the search
for effective disease-modifying therapeutic options. The fact that many trials in critical care medicine have not
identified a treatment benefit is probably due, in part, to the underlying heterogeneity of critical care syndromes.
Numerous approaches have been proposed to divide populations of critically ill patients into more meaningful
subgroups (subphenotypes), some of which might be more useful than others. Subclassification systems driven by
clinical features and biomarkers have been proposed for acute respiratory distress syndrome, sepsis, acute kidney
injury, and pancreatitis. Identifying the systems that are most useful and biologically meaningful could lead to a
better understanding of the pathophysiology of critical care syndromes and the discovery of new treatment targets,
and allow recruitment in future therapeutic trials to focus on predicted responders. This Review discusses proposed
subphenotypes of critical illness syndromes and highlights the issues that will need to be addressed to translate
subphenotypes into clinical practice.
Original languageEnglish
Pages (from-to)631-643
Number of pages13
JournalThe Lancet Respiratory Medicine
Issue number6
Publication statusPublished - 01 Jun 2020

Bibliographical note

Copyright © 2020 Elsevier Ltd. All rights reserved.


  • Acute Kidney Injury/classification
  • Critical Care/methods
  • Critical Illness/classification
  • Humans
  • Phenotype
  • Precision Medicine/methods
  • Respiratory Distress Syndrome, Adult/classification
  • Translational Medical Research


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