Evidence map›Paper›PMID 40261380›Full record

ArticleIntensive care medicine2025

Outcomes in immunocompromised patients with acute hypoxemic respiratory failure treated by high-flow nasal oxygen.

Elie Azoulay, Mélanie Métais, Virginie Lemiale, Djamel Mokart, Anne-Sophie Moreau, Emmanuel Canet, Achille Kouatchet, Laurent Argaud, Peter Pickkers, Philippe R Bauer and 8 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Intensive care medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Review
  2. Critical care in hematologic emergencies.Intensive care medicine · 2026
    Article
  3. Article
  4. Update on acute respiratory failure.Intensive care medicine · 2026
    Article
  5. Article
  6. Observational
  7. Review
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Elie AzoulayMedical Intensive Care Unit, AP-HP, Saint-Louis Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France. elie.azoulay@aphp.fr.ORCID 0000-0002-8162-1508
Mélanie MétaisMedical Intensive Care Unit, AP-HP, Saint-Louis Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France.
Virginie LemialeMedical Intensive Care Unit, AP-HP, Saint-Louis Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France.
Djamel MokartInstitut Paoli-Calmettes, Marseille, France.
Anne-Sophie MoreauMédecine Intensive et Réanimation, Centre Hospitalier Universitaire de Lille, Lille, France.
Emmanuel CanetCentre Hospitalier Universitaire de Nantes, Nantes Université, Nantes, France.
Achille KouatchetCentre Hospitalier Universitaire d'Angers, Angers, France.
Laurent ArgaudCentre Hospitalier Universitaire de Lyon, Hôpital Edouard Herriot, Lyon, France.
Peter PickkersDepartment of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Philippe R BauerDepartment of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, USA.
Andry van de LouwDivision of Pulmonary and Critical Care Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, USA.
Ignacio Martin-LoechesDepartment of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization, (MICRO), St. James' Hospital, Dublin, Ireland.
Sangeeta MehtaInterdepartmental Division of Critical Care Medicine, Department of Medicine, Sinai Health System, University of Toronto, Toronto, Canada.
Christophe GiraultCHU Rouen, Medical Intensive Care Unit, Université de Rouen Normandie, Normandie Université, GRHVN UR 3830, Rouen, France.
Florent WalletCentre Hospitalier Lyon Sud Hospices Civils de Lyon, Pierre-Bénite, France.
Frédéric PèneAssistance Publique - Hôpitaux de Paris, Hôpital Cochin, Service de Médecine Intensive Réanimation, Institut Cochin, Université Paris Cité, INSERM U1016, CNRS UMR8104, Paris, France.
Alexandre DemouleDépartement R3S, Service de Médecine Intensive - Réanimation, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Site Pitié-Salpêtrière, Paris, France.
Alexis MaillardMedical Intensive Care Unit, AP-HP, Saint-Louis Hospital, Paris-Cité University, INSERM UMR1342 Institut de Recherche Saint-Louis, Paris, France.

Funding

GRRR-OH 2024 HFNV
6 · The paper itself

Abstract

purposeAcute hypoxemic respiratory failure (ARF) is a major challenge in immunocompromised patients, often complicated by severe respiratory distress and organ dysfunction. High-flow nasal oxygen (HFNO) therapy is the standard of care, but data on its effectiveness and outcomes are limited. This study evaluated the outcomes of HFNO in this population, predictors of invasive mechanical ventilation (IMV), and factors associated with 28-day mortality.

methodsWe analyzed data from a multicenter cohort of 986 immunocompromised patients with ARF treated with HFNO. Predictive factors for IMV and mortality were assessed using multivariable survival models, and the predictive value of the respiratory rate‑oxygenation (ROX) index for IMV was evaluated.

resultsPatients had a median age of 63 years [IQR 54-70], and 66% were male. Primary causes of immunosuppression included hematologic malignancies (55%), solid tumors (30%), and solid-organ transplantation (10%). Bacterial pneumonia (40%) and opportunistic infections (15%) were the most common ARF etiologies. IMV was required in 46% of patients. Day 28 mortality was 33%, with better outcomes for solid-organ transplant recipients compared to hematologic malignancy or solid tumor (70% vs. 48% vs. 51% mortality, respectively). Predictors of IMV included a lower ROX index, higher respiratory rates, and lower PaO

conclusionsHFNO outcomes in immunocompromised patients with ARF vary widely, influenced by immunosuppression type, ARF etiology, and clinical factors. Optimizing treatment and identifying high-risk patients could improve outcomes. Prospective studies are needed to enhance HFNO strategies.

Indexed as

HypoxiaImmunocompromised HostOxygen Inhalation TherapyRespiratory InsufficiencyAgedCohort StudiesFemaleHumansMaleMiddle AgedRespiration, ArtificialRetrospective StudiesTreatment OutcomeARDSHematologyNeutropeniaOncologyRespiratory distressTransplantation

Identifiers

PMID40261380

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.