Management of acute respiratory failure in interstitial lung diseases: overview and clinical insights

The interstitial lung diseases (ILDs), are an extensive range of lung diseases, rather than a single disease entity. These diseases are often grouped together because they have similarities in clinical presentation, radiographic changes, physiological features, and symptoms. Despite their similarities, these diseases have a variety of aetiologies, treatments, and prognoses. The rate of onset of symptoms is very variable. Some patients present with long-standing radiological symptoms, often found opportunistically. Other patients present with acute onset symptoms, rapidly developing respiratory failure and ultimately progressing to death. This chapter covers the presentation, clinical findings, diagnosis, common causes, and associated investigations. Common ILDs are also described.

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Failure of non-invasive respiratory support after 6 hours from initiation is associated with ICU mortality

PLoS ONE ◽

10.1371/journal.pone.0251030 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0251030

Author(s):

Mitsuaki Nishikimi ◽

Kazuki Nishida ◽

Yuichiro Shindo ◽

Muhammad Shoaib ◽

Daisuke Kasugai ◽

...

Keyword(s):

Respiratory Failure ◽

Acute Respiratory Failure ◽

Lung Diseases ◽

Ventilatory Support ◽

Respiratory Support ◽

Positive Pressure ◽

Icu Mortality ◽

Failure Group ◽

Non Invasive ◽

Significant Difference

A previous study has shown that late failure (> 48 hours) of high-flow nasal cannula (HFNC) was associated with intensive care unit (ICU) mortality. The aim of this study was to investigate whether failure of non-invasive respiratory support, including HFNC and non-invasive positive pressure ventilation (NPPV), was also associated with the risk of mortality even if it occurs in the earlier phase. We retrospectively analyzed 59 intubated patients for acute respiratory failure due to lung diseases between April 2014 and June 2018. We divided the patients into 2 groups according to the time from starting non-invasive ventilatory support until their intubation: ≤ 6 hours failure and > 6 hours failure group. We evaluated the differences in the ICU mortality between these two groups. The multivariate logistic regression analysis showed the highest mortality in the > 6 hours failure group as compared to the ≤ 6 hours failure group, with a statistically significant difference (p < 0.01). It was also associated with a statistically significant increased 30-day mortality and decreased ventilator weaning rate. The ICU mortality in patients with acute respiratory failure caused by lung diseases was increased if the time until failure of HFNC and NPPV was more than 6 hours.

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Drugs associated with drug-induced interstitial lung diseases

Kachestvennaya klinicheskaya praktika ◽

10.37489/2588-0519-2021-2-39-51 ◽

2021 ◽

pp. 39-51

Author(s):

O. D. Ostroumova ◽

A. I. Listratov ◽

A. I. Kochetkov ◽

D. A. Sychev

Keyword(s):

Respiratory Failure ◽

Lung Diseases ◽

Underlying Disease ◽

Interstitial Lung Diseases ◽

Diagnostic Methods ◽

Lung Damage ◽

Close Monitoring ◽

Disease Treatment ◽

Drug Induced ◽

The Relationship

Interstitial lesion is one of the causes of respiratory failure. Drugs are a modifiable etiological factor of lung damage. Medications most commonly associated with drug-induced interstitial lung disease include antineoplastic drugs, disease-modifying anti-rheumatic drugs and amiodarone. According to the latest literature data, the previously described link between anti-rheumatic drugs and interstitial lung diseases is very inconsistent. It may even be a protective effect of this group of drugs on the lung tissue. The relationship between statin use and interstitial lesions is also complex and not fully understood. It is necessary to carefully assess the appearance of respiratory tract complaints in patients taking statins as in other groups of patients. Prescription of additional diagnostic methods is necessary to close monitoring and prevention the toxic effect of these drugs. These actions, as well as the potential prescription of steroid therapy and change in the underlying disease treatment approaches, are an important factor in reducing the incidence of respiratory failure in the population.

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Modern problems of interstitial lung diseases in children

Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) ◽

10.21508/1027-4065-2021-66-3-5-11 ◽

2021 ◽

Vol 66 (3) ◽

pp. 5-11

Author(s):

Yu. L. Mizernitskiy ◽

N. S. Lev

Keyword(s):

Respiratory Failure ◽

Lung Transplantation ◽

Lung Tissue ◽

Lung Diseases ◽

Clinical Medicine ◽

Interstitial Lung Diseases ◽

Severe Respiratory Failure ◽

Large Group ◽

Current State

Interstitial lung diseases refer to a large group of diseases with a severe course and unfavorable prognosis, since the most forms of these diseases cause irreversible fibrosis of the lung tissue and severe respiratory failure. Lung transplantation remains the only way to save the patient’s.The article highlights the current state of the problem, achievements and prospects in the study, diagnosis and approaches to the treatment of interstitial lung diseases in children. The authors emphasize that this direction is one of the most relevant in pediatric pulmonology and clinical medicine in general.

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