The characteristics and outcomes of patients with idiopathic pulmonary fibrosis admitted to the ICU with acute respiratory failure

Rory A Smith; Matheni Sathananthan; Prabhleen Kaur; Niranjan Jeganathan

doi:10.1016/j.hrtlng.2020.05.006

The characteristics and outcomes of patients with idiopathic pulmonary fibrosis admitted to the ICU with acute respiratory failure

Heart Lung. 2021 Jan-Feb;50(1):192-196. doi: 10.1016/j.hrtlng.2020.05.006. Epub 2020 Jun 8.

Authors

Rory A Smith¹, Matheni Sathananthan², Prabhleen Kaur³, Niranjan Jeganathan⁴

Affiliations

¹ Department of Internal Medicine, Arrowhead Regional Medical Center, Colton, CA, 92324, USA.
² Department of Medicine, Division of Endocrinology, Loma Linda University Health, Loma Linda, CA, 92354, USA.
³ College of Arts and Sciences, University of California San Diego, La Jolla,CA 92093, USA.
⁴ Department of Medicine, Division of Pulmonary, Critical Care, Hyperbaric, Allergy and Sleep Medicine, Loma Linda University Health, 11234 Anderson Street, Room 6424, Loma Linda, CA 92354, USA. Electronic address: njeganathan@llu.edu.

PMID: 32522418
DOI: 10.1016/j.hrtlng.2020.05.006

Abstract

Background: To date, studies have provided conflicting results regarding the outcomes of patients with Idiopathic Pulmonary Fibrosis (IPF) admitted to the ICU with acute respiratory failure (ARF).

Objective: To understand the characteristics and outcomes of these patients.

Methods: Retrospective study using a large single-center ICU database. We identified 48 unique patients with IPF admitted for ARF from 2001-2012.

Results: The most common causes of ARF were IPF exacerbation and pneumonia. The overall hospital mortality rate was 43.8% and was 56.7% in those who required invasive mechanical ventilation (IMV). In patients requiring IMV for IPF exacerbation, the mortality rate was 81.3%. In multiple regression analysis, the presence of diabetes mellitus was associated with decreased mortality whereas the need for IMV was associated with increased mortality.

Conclusions: Although the overall mortality rate for IPF patients with ARF has improved, the need for IMV due to IPF exacerbations is associated with increased mortality.

Keywords: Acute respiratory failure; Diabetes mellitus; Idiopathic pulmonary fibrosis; Intensive care unit; Mechanical ventilation; Organ failure.

MeSH terms

Acute Disease
Humans
Idiopathic Pulmonary Fibrosis* / complications
Idiopathic Pulmonary Fibrosis* / epidemiology
Idiopathic Pulmonary Fibrosis* / therapy
Intensive Care Units
Respiration, Artificial
Respiratory Insufficiency* / etiology
Respiratory Insufficiency* / therapy
Retrospective Studies