ICU Cases · Oncology & immunocompromised
Hot case — the bedside: the ICI pneumonitis
A CICM hot case on the ICI pneumonitis — the STOP the ICI, the high-dose steroids, the CT and the bronchoscopy, and the severe (the infliximab or the mycophenolate).
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Prompt
A patient on a PD-1 inhibitor for a melanoma presents with progressive dyspnoea and hypoxia. Assess and manage the suspected ICI pneumonitis.
Presentation
You are called to the bedside of a 60-year-old man on the pembrolizumab (a PD-1 inhibitor) for a metastatic melanoma (the last dose 3 weeks ago). He has developed the progressive dyspnoea, the dry cough, and the hypoxia (the saturation of 88 per cent) over the last 3 days. The chest X-ray shows the bilateral infiltrates.[1]
References2ShowHide
- [1]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [2]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.