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The following is a summary of “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,” published in the February 2025 issue of Critical Care Medicine by Yvin et al.
Researchers conducted a retrospective study to investigate the response to oxygenation strategies over time and linkage with survival in immunocompromised patients with acute hypoxemic respiratory failure.
They executed a post hoc analysis of the EFRAIM study by applying a nonparametric longitudinal clustering technique (longitudinal K-mean) and patients with critically illness and immunocompromised were admitted for an acute respiratory failure.
The results showed that 1,547 patients without invasive mechanical ventilation (iMV) at ICU admission were included and 3 clusters of oxygenation changes over time were identified. Cluster A had 12.3% iMV use with a high survival rate (n = 717, 46.3%). Cluster B had 32.9% iMV use and 97% ICU mortality (n = 499, 32.3%). Cluster C had 37.5% iMV use and 0.3% ICU mortality (n = 331, 21.4%). These clusters showed high discrimination. After adjusting for confounders, clusters B and C were independently linked to iMV need (odds ratio [OR] 9.87; 95% CI, 7.26–13.50 and OR 19.8; 95% CI, 13.7–29.1).
Investigators concluded that distinct response clusters to initial oxygenation reliably predicted the need for iMV and hospital mortality.
