Respiratory failure & ventilation
Do Thresholds for Invasive Ventilation in Hypoxemic Respiratory Failure Exist? A Cohort Study
Authors' conclusion
The probability of invasive ventilation within 3 hours of meeting physiologic thresholds was low and associated with patient race/ethnicity.
Study context
- Population
- ICU patients with hypoxemic respiratory failure receiving FiO2 of 0.4 or more via nonrebreather mask, NIV or HFNC
- Participants
- 4,726 patients
- Exposure
- Probability of invasive ventilation within 3 hours after meeting each of 17 physiologic thresholds
- Medical Information Mart for Intensive Care (MIMIC)n = 3,365
- AmsterdamUMCdbn = 1,361
- Outcome
- Highest probability of invasive ventilation within 3 hours of meeting a threshold
- Follow-up
- Within 3 hours
Methodological detailstwo ICU databases (MIMIC-IV, AmsterdamUMCdb)
- Two ICU databases (MIMIC-IV, AmsterdamUMCdb)
Main finding
As reported in the abstract
- MIMIC: after prespecified neurologic or respiratory criteria while on vasopressors
- 20%
- MIMIC: after PaO2/FiO2 <80 mm Hg
- 19%
- AmsterdamUMCdb: after vasopressor initiation
- 34%
- AmsterdamUMCdb: after SpO2/FiO2 <90
- 25%
- MIMIC: after threshold from randomized trials
- 9%
- AmsterdamUMCdb: after threshold from randomized trials
- 13%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CrI) | |
|---|---|---|
| Association of race/ethnicity with probability of invasive ventilation after meeting a threshold (MIMIC)Black vs White · CrI | 0.75 (0.57–0.96) | |
| Association of race/ethnicity with probability of invasive ventilation after meeting a threshold (MIMIC)Asian vs White · CrI | 0.6 (0.35–0.95) | |
| 0.20.5125Odds ratio (log scale) |
- Association of race/ethnicity with probability of invasive ventilation after meeting a threshold (MIMIC): 95% CrI
Invasive ventilation, overall
- Invasive ventilation occurred (1,320 patients)
- 28%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Do Thresholds for Invasive Ventilation in Hypoxemic Respiratory Failure Exist? A Cohort Study. Am J Respir Crit Care Med. Published 1 February 2023. doi:10.
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