Related Experiment Video
Updated: Nov 11, 2025
05:39
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
1.9K
Survival in Immunocompromised Patients Ultimately Requiring Invasive Mechanical Ventilation: A Pooled Individual
Guillaume Dumas1,2, Virginie Lemiale1,2, Nisha Rathi3
1Medical ICU, Saint-Louis Teaching Hospital, Paris, France.
American Journal of Respiratory and Critical Care Medicine
|March 22, 2021
Summary
Survival improved for immunocompromised patients requiring invasive mechanical ventilation. Delayed intubation after acute respiratory failure significantly increased mortality risk, highlighting the importance of timely intervention.
Area of Science:
- Critical Care Medicine
- Immunology
- Respiratory Medicine
Background:
- Acute respiratory failure (ARF) poses a high mortality risk in immunocompromised patients, especially those needing invasive mechanical ventilation.
- Noninvasive oxygenation/ventilation strategies aim to prevent intubation, but their impact on mortality, particularly with delayed intubation, remains uncertain.
Purpose of the Study:
- To analyze survival trends in immunocompromised patients undergoing invasive mechanical ventilation.
- To evaluate the impact of delayed intubation following noninvasive strategy failure on patient mortality.
Main Methods:
- A systematic review and meta-analysis of individual patient data from 24 studies (2008-2018) involving immunocompromised adults with ARF.
- Mixed-effect models were used to assess the association between delayed intubation and hospital mortality, with survival rates analyzed over time.
Main Results:
- The study included 11,087 patients; 74% received early intubation (within 24 hours of ICU admission). Crude mortality was 53.2%.
- Survival rates improved significantly over time (1995-2017). Each day of delayed intubation increased mortality risk (OR, 1.38).
- Early intubation was linked to lower mortality (OR, 0.83), a finding consistent across different initial oxygenation strategies and confirmed by propensity score analysis.
Conclusions:
- Survival has improved for immunocompromised patients requiring invasive mechanical ventilation.
- The timing of intubation is a critical predictor of mortality, indicating that delays in initiating invasive ventilation after initial oxygenation failure are detrimental.
More Related Videos
Related Concept Videos
01:23Mechanical Ventilation II: Invasive Ventilation
415
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
415
01:23Mechanical Ventilation III: Noninvasive Ventilation
354
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
354
01:30Pneumonia III: Complications and Assessment
569
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
569
01:29Mechanical Ventilation I: Indication and Settings
1.7K
Mechanical ventilation is a life-saving technique for managing acute respiratory failure and other respiratory complications. The process involves using a machine known as a ventilator to supply oxygen to the lungs and assist in removing carbon dioxide. It serves as a bridge to long-term mechanical ventilation or a temporary measure until ventilatory support is discontinued. The ventilator can maintain this function for a prolonged period, providing critical support for patients until they can...
1.7K
01:21Acute Respiratory Failure-II
631
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
631
01:30Acute Respiratory Failure-III
471
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
471