{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:51:48Z","timestamp":1791305508016,"version":"4.3.1"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>Acute hypoxemic respiratory failure (AHRF) is a leading cause of ICU admission and is associated with significant morbidity and mortality. Yet, epidemiological data on AHRF remain limited, and current management strategies largely derive from studies on acute respiratory distress syndrome (ARDS). We examined the prevalence of AHRF among ICU patients receiving supplemental oxygen or respiratory support for at least 4 hours, as well as initial respiratory support strategies and associated outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DESIGN:<\/jats:title>\n                    <jats:p>Multicenter registry-based cohort study, 2014\u20132023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SETTING:<\/jats:title>\n                    <jats:p>Nine university of Toronto affiliated ICUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>\n                      Adult ICU patients receiving supplemental oxygen or respiratory support who met AHRF criteria, defined as Pa\n                      <jats:sc>o<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      \/F\n                      <jats:sc>io<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      less than or equal to 300\u2009mm Hg or, if Pa\n                      <jats:sc>o<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      was not available, peripheral oxygen saturation (SpO\n                      <jats:sub>2<\/jats:sub>\n                      )\/F\n                      <jats:sc>io<\/jats:sc>\n                      <jats:sub>2<\/jats:sub>\n                      less than or equal to 315, within the first 24 hours of ICU admission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>INTERVENTIONS:<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MEASUREMENTS AND MAIN RESULTS:<\/jats:title>\n                    <jats:p>The primary outcome was AHRF prevalence. Secondary outcomes included ICU length of stay, invasive mechanical ventilation (IMV) duration, ventilator-free days, and ICU mortality, stratified by AHRF severity. Of 21,714 patients recorded in the registry, 10,832 (50%) met AHRF criteria, of whom 76% required IMV. Most received lung-protective ventilation. With increasing AHRF severity, ICU length of stay and IMV duration increased, while ventilator-free days and probability of ICU discharge at 30 days decreased. ICU mortality was 23% overall and 47% among patients on IMV with severe AHRF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>AHRF is common early after ICU admission among patients requiring supplemental oxygen or respiratory support and is frequently managed using ARDS-based strategies. A pragmatic, standardized, and operationally feasible definition of AHRF may improve patient recognition, enable comparisons across studies, and guide future research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ccm.0000000000007284","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:40:26Z","timestamp":1786545626000},"page":"2601-2612","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology, Ventilatory Patterns, and Outcomes in Acute Hypoxemic Respiratory Failure Among ICU Patients Requiring Respiratory Support: A Registry-Based Cohort Study"],"prefix":"10.1097","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7774-5690","authenticated-orcid":false,"given":"Stephan","family":"von D\u00fcring","sequence":"first","affiliation":[{"name":"Division of Intensive Care Medicine, Department of Acute Care Medicine, Geneva University Hospitals, Geneva, Switzerland."},{"name":"Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland."},{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewan","family":"Goligher","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada."},{"name":"Department of Physiology, University of Toronto, Toronto, ON, Canada."},{"name":"Toronto General Hospital Research Institute, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre Carlos Kajdacsy-Balla","family":"Amaral","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada."},{"name":"Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon D.","family":"Rubenfeld","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada."},{"name":"Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall D.","family":"Ferguson","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada."},{"name":"Toronto General Hospital Research Institute, Toronto, ON, Canada."},{"name":"Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada."},{"name":"Department of Medicine, Division of Respirology and Critical Care, University Health Network, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Urner","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada."},{"name":"Toronto General Hospital Research Institute, Toronto, ON, Canada."},{"name":"Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddy","family":"Fan","sequence":"additional","affiliation":[{"name":"Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada."},{"name":"Toronto General Hospital Research Institute, Toronto, ON, Canada."},{"name":"Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada."},{"name":"Department of Medicine, Division of Respirology and Critical Care, University Health Network, Toronto, ON, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"R1-20261006","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.jcrc.2014.05.017","article-title":"Markers of poor outcome in patients with acute hypoxemic respiratory failure.","volume":"29","author":"Choi","year":"2014","journal-title":"J Crit Care"},{"key":"R2-20261006","first-page":"e0684","article-title":"The PANDORA study: Prevalence and outcome of acute hypoxemic respiratory failure in the pre-COVID-19 era.","volume":"4","author":"Villar","year":"2022","journal-title":"Crit Care Explor"},{"key":"R3-20261006","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/s13613-018-0424-4","article-title":"Hypoxemia in the ICU: Prevalence, treatment, and outcome.","volume":"8","year":"2018","journal-title":"Ann Intensive Care"},{"key":"R4-20261006","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1007\/s001340050983","article-title":"Prevalence, etiologies and outcome of the acute respiratory distress syndrome among hypoxemic ventilated patients. SRLF Collaborative Group on Mechanical Ventilation. Societe de Reanimation de Langue Francaise.","volume":"25","author":"Roupie","year":"1999","journal-title":"Intensive Care Med"},{"key":"R5-20261006","doi-asserted-by":"crossref","first-page":"2003317","DOI":"10.1183\/13993003.03317-2020","article-title":"Outcome of acute hypoxaemic respiratory failure: Insights from the LUNG SAFE study.","volume":"57","author":"Pham","year":"2021","journal-title":"Eur Respir J"},{"key":"R6-20261006","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1007\/s00134-024-07609-y","article-title":"Epidemiology of acute hypoxaemic respiratory failure in Australian and New Zealand intensive care units during 2005-2022. A binational, registry-based study.","volume":"50","author":"Ling","year":"2024","journal-title":"Intensive Care Med"},{"key":"R7-20261006","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1001\/jama.2020.9524","article-title":"Association of noninvasive oxygenation strategies with all-cause mortality in adults with acute hypoxemic respiratory failure: A systematic review and meta-analysis.","volume":"324","author":"Ferreyro","year":"2020","journal-title":"JAMA"},{"key":"R8-20261006","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1007\/s00134-023-07050-7","article-title":"ESICM guidelines on acute respiratory distress syndrome: Definition, phenotyping and respiratory support strategies.","volume":"49","author":"Grasselli","year":"2023","journal-title":"Intensive Care Med"},{"key":"R9-20261006","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1164\/rccm.202311-2011ST","article-title":"An update on management of adult patients with acute respiratory distress syndrome: An official American Thoracic Society Clinical Practice Guideline.","volume":"209","author":"Qadir","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"key":"R10-20261006","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/s13054-016-1443-x","article-title":"The LUNG SAFE study: A presentation of the prevalence of ARDS according to the Berlin definition!","volume":"20","author":"Bellani","year":"2016","journal-title":"Crit Care"},{"key":"R11-20261006","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.chest.2017.11.037","article-title":"Interobserver reliability of the Berlin ARDS definition and strategies to improve the reliability of ARDS diagnosis.","volume":"153","author":"Sjoding","year":"2018","journal-title":"Chest"},{"key":"R12-20261006","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1378\/chest.121.5.1602","article-title":"The epidemiology of acute respiratory failure in critically ill patients(*).","volume":"121","author":"Vincent","year":"2002","journal-title":"Chest"},{"key":"R13-20261006","doi-asserted-by":"crossref","first-page":"28","DOI":"10.15171\/jcvtr.2014.06","article-title":"Comparison of the Spo2\/Fio2 ratio and the Pao2\/Fio2 ratio in patients with acute lung injury or acute respiratory distress syndrome.","volume":"7","author":"Bilan","year":"2015","journal-title":"J Cardiovasc Thorac Res"},{"key":"R14-20261006","doi-asserted-by":"crossref","first-page":"125","DOI":"10.4046\/trd.2020.0126","article-title":"The association between mortality and the oxygen saturation and fraction of inhaled oxygen in patients requiring oxygen therapy due to COVID-19-associated pneumonia.","volume":"84","author":"Choi","year":"2021","journal-title":"Tuberc Respir Dis (Seoul)"},{"key":"R15-20261006","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1164\/rccm.201212-2169OC","article-title":"Evolution of mortality over time in patients receiving mechanical ventilation.","volume":"188","author":"Esteban","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"key":"R16-20261006","first-page":"2526","article-title":"Acute respiratory distress syndrome: The Berlin definition.","volume":"307","author":"Force","year":"2012","journal-title":"JAMA"},{"key":"R17-20261006","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1164\/rccm.202303-0558WS","article-title":"A new global definition of acute respiratory distress syndrome.","volume":"209","author":"Matthay","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"key":"R18-20261006","doi-asserted-by":"crossref","first-page":"604","DOI":"10.4187\/respcare.05500604","article-title":"Delivered oxygen concentrations using low-flow and high-flow nasal cannulas.","volume":"50","author":"Wettstein","year":"2005","journal-title":"Respir Care"},{"key":"R19-20261006","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1164\/rccm.202009-3536OC","article-title":"Effect of lowering Vt on mortality in acute respiratory distress syndrome varies with respiratory system elastance.","volume":"203","author":"Goligher","year":"2021","journal-title":"Am J Respir Crit Care Med"},{"key":"R20-20261006","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00134-016-4505-2","article-title":"Ventilator-related causes of lung injury: The mechanical power.","volume":"42","author":"Gattinoni","year":"2016","journal-title":"Intensive Care Med"},{"key":"R21-20261006","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1164\/rccm.201804-0692OC","article-title":"Physiologic analysis and clinical performance of the ventilatory ratio in acute respiratory distress syndrome.","volume":"199","author":"Sinha","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"R22-20261006","doi-asserted-by":"crossref","first-page":"107560","DOI":"10.1016\/j.cct.2024.107560","article-title":"Designing a Bayesian adaptive clinical trial to evaluate novel mechanical ventilation strategies in acute respiratory failure using integrated nested Laplace approximations.","volume":"142","author":"Hosseini","year":"2024","journal-title":"Contemp Clin Trials"},{"key":"R23-20261006","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1056\/NEJMoa2103417","article-title":"Therapeutic anticoagulation with heparin in critically ill patients with Covid-19.","volume":"385","author":"Goligher","year":"2021","journal-title":"N Engl J Med"},{"key":"R24-20261006","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/jama.2016.0291","article-title":"Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries.","volume":"315","author":"Bellani","year":"2016","journal-title":"JAMA"},{"key":"R25-20261006","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1007\/s00134-020-06035-0","article-title":"Missed or delayed diagnosis of ARDS: A common and serious problem.","volume":"46","author":"Bellani","year":"2020","journal-title":"Intensive Care Med"},{"key":"R26-20261006","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1097\/CCM.0000000000003000","article-title":"The randomized educational acute respiratory distress syndrome diagnosis study: A trial to improve the radiographic diagnosis of acute respiratory distress syndrome.","volume":"46","author":"Goddard","year":"2018","journal-title":"Crit Care Med"},{"key":"R27-20261006","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1056\/NEJMc2029240","article-title":"Racial bias in pulse oximetry measurement.","volume":"383","author":"Sjoding","year":"2020","journal-title":"N Engl J Med"},{"key":"R28-20261006","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.chest.2016.01.003","article-title":"Nonlinear imputation of Pao2\/Fio2 from Spo2\/Fio2 among patients with acute respiratory distress syndrome.","volume":"150","author":"Brown","year":"2016","journal-title":"Chest"},{"key":"R29-20261006","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/resp.12560","article-title":"Accuracy of PaO2\/FiO2 calculated from SpO2 for severity assessment in ED patients with pneumonia.","volume":"20","author":"Sanz","year":"2015","journal-title":"Respirology"},{"key":"R30-20261006","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1378\/chest.07-0617","article-title":"Comparison of the SpO2\/FIO2 ratio and the PaO2\/FIO2 ratio in patients with acute lung injury or ARDS.","volume":"132","author":"Rice","year":"2007","journal-title":"Chest"},{"key":"R31-20261006","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1001\/jama.2012.13730","article-title":"Association between use of lung-protective ventilation with lower tidal volumes and clinical outcomes among patients without acute respiratory distress syndrome: A meta-analysis.","volume":"308","author":"Serpa Neto","year":"2012","journal-title":"JAMA"},{"key":"R32-20261006","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1097\/CCM.0000000000001189","article-title":"Lung-protective ventilation with low tidal volumes and the occurrence of pulmonary complications in patients without acute respiratory distress syndrome: A systematic review and individual patient data analysis.","volume":"43","author":"Neto","year":"2015","journal-title":"Crit Care Med"},{"key":"R33-20261006","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1056\/NEJM200005043421801","article-title":"Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.","volume":"342","author":"Brower","year":"2000","journal-title":"N Engl J Med"},{"key":"R34-20261006","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1056\/NEJMsa1410639","article-title":"Driving pressure and survival in the acute respiratory distress syndrome.","volume":"372","author":"Amato","year":"2015","journal-title":"N Engl J Med"},{"key":"R35-20261006","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s00134-018-5311-9","article-title":"Plateau and driving pressure in the presence of spontaneous breathing.","volume":"45","author":"Bellani","year":"2019","journal-title":"Intensive Care Med"},{"key":"R36-20261006","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1164\/rccm.202005-2046OC","article-title":"Compliance phenotypes in early acute respiratory distress syndrome before the COVID-19 pandemic.","volume":"202","author":"Panwar","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"R37-20261006","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1007\/s00134-005-2627-z","article-title":"The concept of \u201cbaby lung.\u201d","volume":"31","author":"Gattinoni","year":"2005","journal-title":"Intensive Care Med"},{"key":"R38-20261006","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/S2213-2600(19)30138-9","article-title":"Personalised mechanical ventilation tailored to lung morphology versus low positive end-expiratory pressure for patients with acute respiratory distress syndrome in France (the LIVE study): A multicentre, single-blind, randomised controlled trial.","volume":"7","author":"Constantin","year":"2019","journal-title":"Lancet Respir Med"}],"container-title":["Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/CCM.0000000000007284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:01:23Z","timestamp":1791302483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/CCM.0000000000007284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":38,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/ccm.0000000000007284","relation":{},"ISSN":["0090-3493","1530-0293"],"issn-type":[{"value":"0090-3493","type":"print"},{"value":"1530-0293","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]}}}