Canonical critical care syndromes such as sepsis and acute respiratory distress syndrome (ARDS) include patients with markedly heterogeneous biology.1 This, paired with decades of randomized controlled trials (RCTs) that were traditionally viewed as "negative," has stalled progress in improving patient outcomes.2 However, emerging awareness of sub-phenotypes based on differences in biomarker profiles and resulting heterogeneous treatment effects have led to calls for precision medicine in which therapies are targeted to those most likely to benefit.3.