ArticleFrontiers in medicine2026
Association of awake prone positioning with clinical outcomes in severe immune checkpoint inhibitor-associated pneumonitis with acute hypoxemic respiratory failure: a propensity-matched retrospective cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Severe immune checkpoint inhibitor (ICI)-associated pneumonitis can lead to acute hypoxemic respiratory failure and substantial mortality. This study evaluated the association between awake prone positioning (APP) and clinical outcomes in patients with clinically diagnosed severe ICI-associated pneumonitis. Methods: In this single-center retrospective cohort study, 120 propensity-matched patients with clinically diagnosed severe ICI-associated pneumonitis and acute hypoxemic respiratory failure between January 2019 and September 2024 were analyzed. Infectious pneumonia, COVID-19 pneumonia, opportunistic infection, tumor progression, radiation pneumonitis, cardiogenic pulmonary edema, pulmonary embolism, diffuse alveolar hemorrhage, and other dominant alternative causes of respiratory failure were excluded through structured diagnostic adjudication. Patients were classified into the APP group ( Results: APP was associated with a higher PaO₂/FiO₂ ratio at 168 h (268 ± 52 vs. 201 ± 49 mmHg, Conclusion: In this retrospective propensity-matched cohort study, APP was associated with improved oxygenation and lower intubation rates in patients with clinically diagnosed severe ICI-associated pneumonitis. Associations with shorter ICU stay and lower observed 28-day mortality should be interpreted cautiously because of the observational design, potential residual confounding, and possible survivor or tolerance bias.
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