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Ther Adv Respir Dis. 2019 Jan-Dec;13:1753466619847130. doi: 10.1177/1753466619847130.

High-flow nasal cannula oxygen therapy to treat acute respiratory failure in patients with acute exacerbation of idiopathic pulmonary fibrosis.

Author information

1
U.O. Fisiopatologia Respiratoria, Azienda Ospedaliera di Padova, Via Giustiniani 2, 35128 Padova, Italy.
2
Department of Cardiological, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
3
Veneto Institute of Oncology IOV, IRCCS, Padova, Italy.
4
Department of Radiology, University of Padova, Padova, Italy.

Abstract

BACKGROUND:

Some patients with idiopathic pulmonary fibrosis (IPF) develop acute exacerbation (AE-IPF) leading to severe acute respiratory failure (ARF); despite conventional supportive therapy, the mortality rate remains extremely high. The aim of this study was to assess how a treatment algorithm incorporating high-flow nasal cannula (HFNC) oxygen therapy affects the short-term mortality of patients with AE-IPF who develop ARF.

METHOD AND DESIGN:

A retrospective cohort analysis was conducted.

PATIENTS AND INTERVENTIONS:

The study consisted of 17 patients with AE-IPF admitted to a respiratory intensive care unit (RICU) for ARF managed using a treatment algorithm incorporating HFNC. The outcome measure was mortality rate during their stay in the RICU.

RESULTS:

Implementation of the treatment algorithm led to a successful outcome in nine patients and to a negative one in eight patients (47.1%) who died within 39 days of being admitted to the RICU. The survival rate was 70.6% (±0.1 %) at 15 days, 52.9% (±0.1%) at 30 days, 35.3% (±0.1%) at 90 days, and 15.6% (±9.73 %) at 365 days. Overall, 4 out of 10 patients who did not respond to conventional oxygen therapy showed a satisfactory response to HFNC.

CONCLUSIONS:

Short-term mortality fell to below 50% when a treatment algorithm incorporating HFNC was implemented in a group of patients with AE-IPF admitted to a RICU for ARF. Patients not responding to conventional oxygen therapy seemed to benefit from HFNC. The reviews of this paper are available via the supplementary material section.

KEYWORDS:

acute respiratory failure; high-flow nasal cannula; idiopathic pulmonary fibrosis; non-invasive mechanical ventilation

PMID:
31170875
PMCID:
PMC6557021
DOI:
10.1177/1753466619847130
[Indexed for MEDLINE]
Free PMC Article

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