Title: Respiratory Complications of ICIs<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<u><strong>Respiratory Complications of ICIs</strong></u></p>
<ul>
<li>
Acute respiratory failure (ARF) is the leading cause of ICU admission for immunocompromised patients.</li>
<li>
While infectious etiologies remain the most common cause of ARF in these patients, there is an increasing prevalence of non-infectious, treatment-related causes.</li>
<li>
Immune check-point inhibitors (ICIs) are now used with increasing frequency, and can cause severe pulmonary toxicity in approximately 6% of patients.</li>
<li>
Pearls for ICI pulmonary toxicity include:
<ul>
<li>
Acute pneumonitis is the most common presentation</li>
<li>
Median time of onset of approximately 4 months after treatment initiation</li>
<li>
Symptoms include dry cough, hypoxemia, and infiltrates not c/w CHF, infection, or progression of malignancy</li>
<li>
Treatment is to DC the ICI and initiate steroids</li>
</ul>
</li>
</ul>
<p>
</p>
<fieldset><legend>References</legend>
<p>
Ferreyro BL, Munshi L. Causes of acure respiratory failure in the immunocompromised host. <em>Curr Opin Crit Care.</em> 2019;25:21-8. </p>
</fieldset>