Responsible Precision Medicine in Pediatric Acute Respiratory Distress Syndrome: The Challenge of Searching for Biomarker-Driven Earlier Diagnosis, Effective Treatment, and Stratified Outcomes

The development of intensive care medicine and of the therapies it enabled has been a major breakthrough for the survival of both pediatric and adult patients once thought beyond therapeutic improvement. Advances in diagnosis and treatment have been achieved through increasingly considering the patient as a unique individual endowed with distinctive characteristics, a specific complexity and, therefore, that a patient’s pathology is itself unique and could only overlap other patients’ disease presentations with difficulty. The trend in current literature is essentially directed toward genomic investigations while addressing epigenetic, transcriptional, and proteomic issues of posttranslational modifications, metabolic, and environmental factors that determine an individual patient’s response to disease and treatment. As more analytical and diagnostic techniques become incorporated into clinical practice, a transition from personalized to accurate precision medicine is beginning to emerge through initiatives that afford a holistic approach to an individual patient’s condition.