Introduction. Pulmonary fibrosis is a heterogeneous group of chronic lung
diseases of unclear pathogenesis, with progressive, irreversible development
of various forms of fibrotic processes in the lung, whose incidence and
mortality rate increases worldwide. Prognostic Evaluation. Some clinical
forms have a long, stable phase, some are slowly progressive, and some have a
very rapid progression from diagnosis to death. Their clinical course is
characterized by acute exacerbations with high mortality. The staging of this
disease includes diagnostics of the stable condition, progression and the end
stage of disease. This paper presents the diagnostic criteria necessary for
the diagnosis of pulmonary fibrosis and its monitoring. The latest research
suggests that the decrease in forced vital capacity values by more than 10%
during the 24 weeks doubles the risk of death over the next 12 months, and
the reduction in the 6-minute walk test by 50 meters increases it four times.
Therefore, monitoring of these prognostic parameters is now regarded as the
most reliable predictor of death in patients with pulmonary fibrosis.
Therapy. This paper also presents the newest recommendations for treatment
modalities based on strong evidence. Conclusion. Treatment of pulmonary
fibrosis in our conditions includes conventional therapy with corticosteroids
as monotherapy or in combination with cyclophosphamide or azathioprine,
whereas the management of end-stage patients consists of long-term controlled
oxygen therapy, noninvasive and mechanical ventilation. Lung transplantation
is considered to be the only therapeutic measure resulting in a significant
extension of life. Unfortunately, our health legislation allows lung
transplantation only in case of cystic fibrosis and this cannot be done in
Serbia but in health centres abroad. Therefore, management in end-stage of
disease is reduced to mere palliative care, even at intensive care units.
Antireflux Surgery Preserves Lung Function in Patients With Gastroesophageal Reflux Disease and End-stage Lung Disease Before and After Lung Transplantation
