# Characterizing clinical and biologic features of persistent hypoxemic respiratory failure

> **NIH NIH F32** · UNIVERSITY OF WASHINGTON · 2022 · $2,500

## Abstract

PROJECT SUMMARY/ABSTRACT
Research: Acute hypoxemic respiratory failure (AHRF) requiring mechanical ventilation is a common, costly
condition with high mortality, yet treatment remains supportive. Identifying effective targeted therapeutics in
heterogeneous conditions like AHRF depends on characterizing subsets, or sub-phenotypes, of patients with
high likelihood of disease related events or response to therapy. This project will characterize a novel sub-
phenotype called persistent hypoxemic respiratory failure (PHRF) among mechanically ventilated AHRF
patients, with PHRF defined by ongoing mechanical ventilation and hypoxemia on ICU day 3. Using clinical
trajectory to define sub-phenotypes in other heterogeneous syndromes has helped delineate patients with
distinct prognosis and highlight biologic mechanisms contributing to trajectories. With large, independent
prospective ICU cohorts from the University of Washington and Vanderbilt University, Dr. Sathe will address
the following aims: (1) identify clinical factors on ICU day 1 associated with PHRF (2) determine biologic
features of PHRF by analyzing ICU day 1 and day 3 circulating biomarkers of lung injury and (3) develop and
validate a multivariable model that predicts PHRF on ICU day 3. Understanding risk factors for PHRF will help
hone in on the early mechanisms important for pathologic responses to lung injury. Advantages to sub-
phenotyping within AHRF rather than ARDS (where prior efforts were focused) include expanding the scope of
patients we target for therapy and improving reliability of study definitions. In addition, discriminating between
patients who will and will not develop PHRF will aid clinical prognostication, resource allocation, and targeted
trial enrollment of patients unlikely to improve with existing treatment. The results will fill key knowledge gaps
prioritized by the NHLBI regarding which factors determine risk for persistent hypoxemia, and the degree to
which these factors overlap across ARDS and other conditions in AHRF.
Candidate/Environment: With the support of the University of Washington, Dr. Mark Wurfel, Dr. Catherine
“Terri” Hough, and biostatistician Leila Zelnick, PhD, this award will help establish Dr. Sathe’s career as a
translational physician-scientist practicing Pulmonary and Critical Care. Through the proposed research, she
will develop fundamental skills for analysis of longitudinal cohort data, contemporary machine learning
methods for prediction, and high-quality measurement and analysis of lung injury biomarkers. This work will
identify biologic pathways for more in-depth study in prospective AHRF cohorts, which she will pursue in a
future K23. She plans to establish a career examining the heterogeneity of acute respiratory failure and other
ICU syndromes, to advance the development of targeted therapeutics for critically ill patients.

## Key facts

- **NIH application ID:** 10690151
- **Project number:** 3F32HL158088-02S1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Neha Alhad Sathe
- **Activity code:** F32 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $2,500
- **Award type:** 3
- **Project period:** 2021-05-16 → 2023-05-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10690151

## Citation

> US National Institutes of Health, RePORTER application 10690151, Characterizing clinical and biologic features of persistent hypoxemic respiratory failure (3F32HL158088-02S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10690151. Licensed CC0.

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