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.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
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
References
Raghu G, Rochwerg B, Zhang Y, et al. An official ATS/ERS/JRS/ALAT clinical practice guideline: treatment of idiopathic pulmonary fibrosis. An update of the 2011 clinical practice guideline. Am J Respir Crit Care Med. 2015;192:e3–19.
Nava S, Rubini F. Lung and chest wall mechanics in ventilated patients with end stage idiopathic pulmonary fibrosis. Thorax. 1999;54:390–5.
Rochwerg B, Brochard L, Elliott MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017;50:1602426.
Faverio P, De Giacomi F, Sardella L, et al. Management of acute respiratory failure in interstitial lung diseases: overview and clinical insights. BMC Pulm Med. 2018;18:70.
Antonelli M, Conti G, Esquinas A, et al. A multiple-center survey on the use in clinical practice of noninvasive ventilation as a first line intervention for ARDS. Crit Care Med. 2007;35:18–25.
Antonelli M, Conti G, Pelosi P, et al. New treatment of acute hypoxemic respiratory failure: non invasive pressure support ventilation delivered by helmet—a pilot controlled trial. Crit Care Med. 2002;30:602–8.
Antonelli M, Pennisi MA, Pelosi P, et al. Noninvasive positive pressure ventilation using a helmet in patients with acute exacerbation of chronic obstructive pulmonary disease: a feasibility study. Anesthesiology. 2004;100:16–24.
Racca F, Appendini L, Gregoretti C, et al. Effectiveness of mask and helmet interfaces to deliver noninvasive ventilation in a human model of resistive breathing. J Appl Physiol. 2005;99:1262–71.
Navalesi P, Costa R, Ceriana P, et al. Non-invasive ventilation in chronic obstructive pulmonary disease patients: helmet versus facial mask. Intensive Care Med. 2007;33:74–81.
Esquinas AM, Papadakos PJ, Carron M, et al. Clinical review: Helmet and non-invasive mechanical ventilation in critically ill patients. Crit Care. 2013;17:223.
Costa R, Navalesi P, Antonelli M, et al. Physiologic evaluation of different levels of assistance during noninvasive ventilation delivered through a helmet. Chest. 2005;128:2984–299.
Chiumello D, Pelosi P, Carlesso E, et al. Noninvasive positive pressure ventilation delivered by helmet vs. standard face mask. Intensive Care Med. 2003;29:1671–9.
Carteaux G, Millan-Guilarte T, De Prost N, et al. Failure of noninvasive ventilation for de novo acute hypoxemic respiratory failure: role of tidal volume. Crit Care Med. 2016;44:282–90.
L’Her E, Deye N, Lellouche F, et al. Physiologic effects of noninvasive ventilation during acute lung injury. Am J Respir Crit Care Med. 2005;172:1112–8.
Tomii K, Tachikawa R, Chin K, et al. Role of non-invasive ventilation in managing life-threatening acute exacerbation of interstitial pneumonia. Intern Med. 2010;49:1341–7.
Rush B, Wiskar K, Berger L, et al. The use of mechanical ventilation in patients with idiopathic pulmonary fibrosis in the United States: a nationwide retrospective cohort analysis. Respir Med. 2016;111:72–6.
Gacouin A, Jouneau S, Letheulle J, et al. Trends in prevalence and prognosis in subjects with acute chronic respiratory failure treated with noninvasive and/or invasive ventilation. Respir Care. 2015;60:210–8.
Fernández-Pérez ER, Yilmaz M, Jenad H, et al. Ventilator settings and outcome of respiratory failure in chronic interstitial lung disease. Chest. 2008;133:1113–9.
Yokoyama T, Tsushima K, Yamamoto H, et al. Potential benefits of early continuous positive pressure ventilation in patients with rapidly progressive interstitial pneumonia. Respirology. 2012;17:315–21.
Vianello A, Arcaro G, Battistella L, et al. Noninvasive ventilation in the event of acute respiratory failure in patients with idiopathic pulmonary fibrosis. J Crit Care. 2014;29:562–7.
Aliberti S, Messinesi G, Gamberini S, et al. Non-invasive mechanical ventilation in patients with diffuse interstitial lung diseases. BMC Pulm Med. 2014;14:194.
Marchioni A, Tonelli R, Ball L, et al. Acute exacerbation of idiopathic pulmonary fibrosis: lessons learned from acute respiratory distress syndrome? Crit Care. 2018;22:80.
Esquinas AM. Fibrosing interstitial pneumonia: is mechanical ventilation always the final alternative for the intensivist? J Thorac Cardiovasc Surg. 2014;147:1113.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
1 Electronic Supplementary Material
Data 47.1
(PPTX 52 kb)
Rights and permissions
Copyright information
© 2022 Springer Nature Switzerland AG
About this chapter
Cite this chapter
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
Download citation
DOI: https://doi.org/10.1007/978-3-030-71298-3_47
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-71297-6
Online ISBN: 978-3-030-71298-3
eBook Packages: MedicineMedicine (R0)