Respiratory failure & ventilation

Escalation of Oxygenation Modalities and Mortality in Critically Ill Immunocompromised Patient With Acute Hypoxemic Respiratory Failure: A Clustering Analysis of a Prospectively Multicenter, Multinational Dataset

Crit Care MedPublished Secondary analysis of the EFRAIM prospective cohort study

Authors' conclusion

This study identified three distinct highly performing clusters of response to initial oxygenation strategy, which reliably predicted the need for iMV requirement and hospital mortality.

Study context

Population
Critically ill immunocompromised patients admitted to ICU for acute respiratory failure, not requiring invasive mechanical ventilation (iMV) at ICU admission
Participants
1,547 participants
Comparison
Clusters of change in oxygenation modality over time
  • Cluster An = 717reference
  • Cluster Bn = 499
  • Cluster Cn = 331
Methodological detailspost hoc analysis, longitudinal K-mean clustering, multinational, observational prospective
  • Post hoc analysis
  • Longitudinal K-mean clustering
  • Multinational
  • Observational prospective

Primary result

As reported in the abstract

Need for iMV
Adjusted for confounders
Each group vs cluster AOdds ratio (95% CI)
Cluster B
9.87(7.26–13.50)
Cluster C
19.8(13.7–29.1)

Further findings

OutcomeCluster BCluster C
ICU mortality97%0.3%

ICU mortality

Cluster A: high survival rate

Original publication

Escalation of Oxygenation Modalities and Mortality in Critically Ill Immunocompromised Patient With Acute Hypoxemic Respiratory Failure: A Clustering Analysis of a Prospectively Multicenter, Multinational Dataset. Crit Care Med. Published 27 February 2025. doi:10.1097/ccm.0000000000006600

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