Respiratory failure & ventilation
Dyspnea is severe and associated with a higher intubation rate in de novo acute hypoxemic respiratory failure
An erratum to this article was published (Crit Care, 26 Feb 2025 ↗)
Authors' conclusion
In patients admitted to the ICU for de novo acute hypoxemic respiratory failure, dyspnea is associated with a higher risk of intubation and with a higher mortality.
Study context
- Population
- ICU patients with de novo acute hypoxemic respiratory failuredyspnea measured in 259
- Participants
- 310 patients
- Comparison
- Dyspnea severity and association with intubation and 90-day mortality
- Primary endpoint
- Intubation (competing risks model accounting for ICU discharge)
Methodological detailscompeting risks model, Cox model
- Competing risks model
- Cox model
Primary result
As reported in the abstract
Baseline dyspnea and intubation
Subdistribution hazard ratio
1.96
P = 0.023
Moderate dyspnea
Subdistribution hazard ratio
2.61
P = 0.023
Severe dyspnea
- Baseline median dyspnea-VAS
- 46 (IQR 16-65) mm
- Dyspnea-VAS ≥ 40 mm at baseline
- 146 patients (56%)
- Intubation rate
- 45%
- SBP independently associated with intubation (sHR)
- 2.56, p < 0.001
- Heart rate independently associated with intubation (sHR)
- 1.94, p = 0.02
- PaO2/FiO2 independently associated with intubation (sHR)
- 0.34, p = 0.028
Further findings
- 90-day mortality
- 20%
- Lower cumulative survival with baseline dyspnea-VAS ≥ 40 mm (logrank test)
- P = 0.049
- SAPS 2 ≥ 25 associated with mortality
- P < 0.001
- Moderate-to-severe dyspnea at baseline and mortality
- P = 0.073
- PaO2/FiO2 and mortality
- P = 0.118
- Treatment arm and mortality
- P = 0.046
Original publication
Dyspnea is severe and associated with a higher intubation rate in de novo acute hypoxemic respiratory failure. Crit Care. Published 23 May 2024. doi:10.
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