Respiratory failure & ventilation
Outcomes in immunocompromised patients with acute hypoxemic respiratory failure treated by high-flow nasal oxygen
Authors' conclusion
HFNO outcomes in immunocompromised patients with ARF vary widely, influenced by immunosuppression type, ARF etiology, and clinical factors.
Study context
- Population
- Immunocompromised patients with acute hypoxemic respiratory failure (ARF) treated with high-flow nasal oxygen (HFNO)
- Participants
- 986 patients
- Outcome
- Outcomes of HFNO: IMV requirement and mortality
- Follow-up
- 28 days
Methodological detailsmultivariable survival models
- Multivariable survival models
Main finding
As reported in the abstract
Invasive mechanical ventilation (IMV) required
46%
Day 28 mortality
33%
Observational data: associations, not effects.
Further findings
Day 28 mortality by cause of immunosuppression (subgroup)
- Solid-organ transplant vs hematologic malignancy vs solid tumor mortality; reported as better outcomes for solid-organ transplant recipients
- 70% vs. 48% vs. 51%
Predictors of IMV
- Lower rate-oxygenation (ROX) index, higher respiratory rates and lower PaO2/FiO2 ratios predicted IMV
Mortality by IMV status
- Mortality highest among patients requiring IMV, particularly those with myeloid malignancies or viral pneumonia
Original publication
Outcomes in immunocompromised patients with acute hypoxemic respiratory failure treated by high-flow nasal oxygen. Intensive Care Med. Published 22 April 2025. doi:10.
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