Respiratory management of critically ill pneumocystis pneumonia patients: a multicenter retrospective study
Authors' conclusion
Through this multicenter observational study of severe PjP patients, although oxygenation strategy was not associated with D90 survival, HFNC support appeared to be associated with a lower intubation rate.
Study context
- Population
- Immunocompromised patients with Pneumocystis jirovecii pneumonia admitted to Intensive Care Unit (ICUs)
- Participants
- 248 patients
- Comparison
- Initial respiratory management: High-Flow Nasal Cannula (HFNC) vs Non-Invasive Ventilation (NIV) vs standard oxygen
- HFNCn = 70
- Standard Oxygen (SO)n = 118reference
- NIVn = 60
- Primary endpoint
- Intubation rate
Methodological detailspropensity score adjustment (inverse probability of treatment weighting (IPTW))
- Propensity score adjustment (IPTW)
Primary result
As reported in the abstract
Each group vs SOEstimate (95% CI)P value
HFNC
weighted HR 0.41(0.24–0.69)
P < 0.001NIV
HR 0.62(0.37–1.02)
P = 0.056Further findings
Independent predictors of death (adjusted survival analysis)
| aHR for death (95% CI) | P value | ||
|---|---|---|---|
| Long-term corticosteroids | 4.03 (2.01–8.08) | P < 0.001 | |
| Solid tumor | 3.37 (1.45–7.86) | P = 0.005 | |
| SOFA score | 1.24 (1.15–1.35) | P < 0.001 | |
| 0.10.31310AHR for death (log scale) |
Survival by initial respiratory support
- Initial respiratory support not associated with survival in Cox multivariable or IPTW analysis
Original publication
Respiratory management of critically ill pneumocystis pneumonia patients: a multicenter retrospective study. Ann Intensive Care. Published 6 August 2025. doi:10.
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