Abstract
Background and objectives: ARF in IPF patients is associated with poor prognosis, therefore NIV could be a good option, avoiding aggressive approaches.
Patients and Methods: NIV treatment in a 70 years old male IPF patient, referred to a RHDCU for ARF. FiO2 (SB) up to 80% increased P/F, but worsened hypercapnia, acidosis, GCS. NIV (FM) in the first 6 h improved gas exchange, but was later replaced by helmet (bad patient’s compliance). Dyspnoea was steadily reduced; the patient was discharged in O2-LT (FiO2 50% 24 h). Two months later he died at home.
Conclusions: NIV has not a significant impact on IPF patient’s survival, but provides relief from dyspnoea and avoids ETI.
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Abbreviations
- %pred:
-
Percent of predicted value
- AE-IPF:
-
Acute exacerbation of IPF
- ARDS:
-
Acute respiratory distress syndrome
- ARF:
-
Acute respiratory failure
- COPD:
-
Chronic obstructive pulmonary disease
- CPAP:
-
Continuous positive airway pressure
- DLCO:
-
Carbon monoxyde diffusion capacity
- DNR:
-
Do not resuscitate
- ETI:
-
Endotracheal intubation
- FBS:
-
Fiberoptic bronchoscopy
- FEV1:
-
Forced expiratory volume in the first second
- FiO2:
-
Inspired oxygen fraction
- FM:
-
Face-mask
- FVC:
-
Forced vital capacity
- GCS:
-
Glasgow Coma score
- GORD:
-
Gastro-oesophageal reflux disease
- HRCT:
-
High resolution computed tomography
- ICU:
-
Intensive care unit
- ILD:
-
Interstitial lung disease
- IMV:
-
Invasive mechanical ventilation
- IPF:
-
Idiopathic pulmonary fibrosis
- MV:
-
Mechanical ventilation
- NIV:
-
Noninvasive mechanical ventilation
- O2-LT:
-
Oxygen long-term therapy
- P/F:
-
PaO2/FiO2: ratio of PaO2 to fraction of inspired oxygen
- PaCO2:
-
Carbon dioxide arterial pressure
- PaO2:
-
Oxygen arterial pressure
- PBW:
-
Predicted body weight
- PFTs:
-
Pulmonary function tests
- PSV:
-
Pressure support ventilation
- pts:
-
Patient/s
- RR:
-
Respiratory rate
- SaO2:
-
Arterial oxygen saturation
- SB:
-
Spontaneous breathing
- TLC:
-
Total lung capacity
- UIP:
-
Usual interstitial pneumonia
- VAP:
-
Ventilator-associated pneumonia
- VILI:
-
Ventilator-induced lung injury
- Vt:
-
Tidal volume
- WOB:
-
Work of breathing
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Mollica, C., Petroianni, A., Conti, V. (2022). Non Invasive Mechanical Ventilation in Idiopathic Pulmonary Fibrosis: A Clinical Case. In: Esquinas, A.M. (eds) Teaching Pearls in Noninvasive Mechanical Ventilation. Springer, Cham. https://doi.org/10.1007/978-3-030-71298-3_47
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