High-flow Nasal Cannula Oxygen Therapy to Treat Acute Respiratory Failure in Patients with Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Overview

Journal Ther Adv Respir Dis

Publisher Sage Publications

Specialties Pharmacology
Pulmonary Medicine

Date 2019 Jun 8

PMID 31170875

Citations 14

Authors

Andrea Vianello

Giovanna Arcaro

Beatrice Molena

Cristian Turato

Fausto Braccioni

Luciana Paladini

Stefania Vio

Silvia Ferrarese

Piera Peditto

Federico Gallan

Marina Saetta

Affiliations

Soon will be listed here.

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.

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