Cholestenoic acid is a prognostic biomarker in acute respiratory distress syndrome

Despite improvements in supportive care, mortality from acute respiratory distress syndrome (ARDS) remains high (approximately 30% to 40%).1 In recent years, several biomarkers of inflammation, epithelial damage, endothelial damage, and coagulation have been identified that show promise for identifying ARDS endotypes with different prognosis and therapeutic responsiveness.1 Unfortunately, few lung-specific biomarkers have been validated, and none have been adopted into routine clinical practice.