The characteristics and outcomes of patients with idiopathic pulmonary fibrosis admitted to the ICU with acute respiratory failure

Smith, Rory A.; Sathananthan, Matheni; Kaur, Prabhleen; Jeganathan, Niranjan

doi:10.1016/j.hrtlng.2020.05.006

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…Der Einfluss der maschinellen Beatmung auf den Verlauf einer diagnostisch gesicherten Lungenfibrose mit akuter hypoxämischer Insuffizienz ist letztlich unklar. Die verfügbare Literatur basiert auf retrospektiven Analysen [191][192][193][194] und zeigt eine hohe ICU-Letalität. Entscheidend sind die kausale Therapierbarkeit der Ursache der hypoxämischen Exzerbation und der Zeit-faktor bis zu einer möglichen klinischen Besserung.…”

Section: Interstitielle Lungenerkrankungunclassified

S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz

Westhoff,

Neumann,

Geiseler

et al. 2023

Pneumologie

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ZusammenfassungDie Leitlinienaktualisierung zeigt die Vorteile sowie die Grenzen der NIV bei der Behandlung von akutem Atemversagen im klinischen Alltag und bei unterschiedlichen Indikationen auf.Die nichtinvasive Beatmung (NIV) hat einen hohen Stellenwert bei der Therapie des hyperkapnischen akuten Atemversagens, da sie die Aufenthaltsdauer und den Krankenhausaufenthalt auf der Intensivstation sowie die Mortalität deutlich reduziert.Patienten mit kardiopulmonalem Ödem und akutem Atemversagen sollten zusätzlich zu notwendigen kardiologischen Eingriffen mit kontinuierlichem positivem Atemwegsdruck (CPAP) und Sauerstoff behandelt werden. Dies sollte bereits präklinisch und in der Notaufnahme erfolgen.Bei anderen Formen des akuten hypoxämischen Atemversagens mit nur leicht bis mäßig gestörtem Gasaustausch (PaO2/FiO2 > 150 mmHg) ergibt sich kein signifikanter Vor- oder Nachteil gegenüber nasaler Sauerstoff-High-Flow-Therapie (HFNO). Bei schweren Formen des ARDS ist die NIV mit einer hohen Rate an Behandlungsversagen und Mortalität verbunden, insbesondere in Fällen mit NIV-Versagen und verzögerter Intubation.Zur Präoxygenierung vor der Intubation sollte NIV verwendet werden. Bei Risikopatienten wird eine NIV empfohlen, um Extubationsversagen zu reduzieren. Im Entwöhnungsprozess von der invasiven Beatmung reduziert NIV das Risiko einer Reintubation bei hyperkapnischen Patienten wesentlich. NIV gilt in der Palliativversorgung als nützlich zur Reduzierung von Dyspnoe und zur Verbesserung der Lebensqualität, hier aber in Konkurrenz zur HFNO, das als komfortabler gilt. Mittlerweile wird die NIV auch im präklinischen Bereich empfohlen, insbesondere bei hyperkapnischem Atemversagen und beim Lungenödem.Bei entsprechender Überwachung auf einer Intensivstation kann NIV auch bei pädiatrischen Patienten mit akuter Ateminsuffizienz erfolgreich eingesetzt werden.

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Section: Interstitielle Lungenerkrankungunclassified

S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz

Westhoff,

Neumann,

Geiseler

et al. 2023

Pneumologie

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“…Furthermore, in contrast to previous studies, our study observed no significant temporal changes in mortality among patients with IPF. Acute exacerbation is the most common reason for mechanical ventilation in patients with IPF [22][23][24]. While guidelines recommend steroid administration for acute exacerbation of IPF, the quality of evidence is very low [3,5].…”

Section: Discussionmentioning

confidence: 99%

“…Third, information on causes of respiratory failure in patients requiring mechanical ventilation was not provided. Several studies have demonstrated that the most common cause of respiratory failure is acute exacerbation, followed by respiratory tract infection, and that the prognosis is worse in patients with www.kjim.org https://doi.org/10.3904/kjim.2023.273 acute exacerbation than in those with respiratory tract infection [22][23][24]. Another study has also reported that the prognosis of patients with ILD and infection is better than that of patients with acute exacerbation.…”

Section: Discussionmentioning

confidence: 99%

Mechanical ventilation in patients with idiopathic pulmonary fibrosis in Korea: a nationwide cohort study

Sim,

Moon,

Choi

et al. 2024

Korean J Intern Med

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Background/Aims: The prognosis of patients with idiopathic pulmonary fibrosis (IPF) and respiratory failure requiring mechanical ventilation is poor. Therefore, mechanical ventilation is not recommended. Recently, outcomes of mechanical ventilation, including those for patients with IPF, have improved. The aim of this study was to investigate changes in the use of mechanical ventilation in patients with IPF and their outcomes over time.Methods: This retrospective, observational cohort study used data from the National Health Insurance Service database. Patients diagnosed with IPF between January 2011 and December 2019 who were placed on mechanical ventilation were included. We analyzed changes in the use of mechanical ventilation in patients with IPF and their mortality using the Cochran- Armitage trend test.Results: Between 2011 and 2019, 1,227 patients with IPF were placed on mechanical ventilation. The annual number of patients with IPF with and without mechanical ventilation increased over time. However, the ratio was relatively stable at approximately 3.5%. The overall hospital mortality rate was 69.4%. There was no improvement in annual hospital mortality rate. The overall 30-day mortality rate was 68.7%, which did not change significantly. The overall 90-day mortality rate was 85.3%. The annual 90-day mortality rate was decreased from 90.9% in 2011 to 83.1% in 2019 (<i>p</i> = 0.028).Conclusions: Despite improvements in intensive care and ventilator management, the prognosis of patients with IPF receiving mechanical ventilation has not improved significantly.

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“…Most IPF patients also have multiple complications, such as heart failure, gastroesophageal reflux disease, obstructive apnea, etc. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Artificial neural network identified the significant genes to distinguish Idiopathic pulmonary fibrosis

Wang

Zhao

et al. 2023

Sci Rep

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Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease that causes irreversible damage to lung tissue characterized by excessive deposition of extracellular matrix (ECM) and remodeling of lung parenchyma. The current diagnosis of IPF is complex and usually completed by a multidisciplinary team including clinicians, radiologists and pathologists they work together and make decision for an effective treatment, it is imperative to introduce novel practical methods for IPF diagnosis. This study provided a new diagnostic model of idiopathic pulmonary fibrosis based on machine learning. Six genes including CDH3, DIO2, ADAMTS14, HS6ST2, IL13RA2, and IGFL2 were identified based on the differentially expressed genes in IPF patients compare to healthy subjects through a random forest classifier with the existing gene expression databases. An artificial neural network model was constructed for IPF diagnosis based these genes, and this model was validated by the distinctive public datasets with a satisfactory diagnostic accuracy. These six genes identified were significant correlated with lung function, and among them, CDH3 and DIO2 were further determined to be significantly associated with the survival. Putting together, artificial neural network model identified the significant genes to distinguish idiopathic pulmonary fibrosis from healthy people and it is potential for molecular diagnosis of IPF.

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The characteristics and outcomes of patients with idiopathic pulmonary fibrosis admitted to the ICU with acute respiratory failure

Cited by 6 publications

References 23 publications

S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz

S2k-Leitlinie Nichtinvasive Beatmung als Therapie der akuten respiratorischen Insuffizienz

Mechanical ventilation in patients with idiopathic pulmonary fibrosis in Korea: a nationwide cohort study

Artificial neural network identified the significant genes to distinguish Idiopathic pulmonary fibrosis

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