Hayat Syed MK, Bruck O, Kumar A, Surani S. Acute exacerbation of interstitial lung disease in the intensive care unit: Principles of diagnostic evaluation and management. World J Crit Care Med 2023; 12(3): 153-164 [PMID: 37397591 DOI: 10.5492/wjccm.v12.i3.153]
Corresponding Author of This Article
Salim Surani, FCCP, MD, MHSc, Academic Editor, Professor, Department of Medicine and Pharmacology, Texas A&M University, 400 BIZZELL ST, College Station, TX 77843, United States. srsurani@hotmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Jun 9, 2023; 12(3): 153-164 Published online Jun 9, 2023. doi: 10.5492/wjccm.v12.i3.153
Acute exacerbation of interstitial lung disease in the intensive care unit: Principles of diagnostic evaluation and management
Muhammad K Hayat Syed, Or Bruck, Anupam Kumar, Salim Surani
Muhammad K Hayat Syed, Or Bruck, Anupam Kumar, Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX 77030, United States
Salim Surani, Department of Medicine and Pharmacology, Texas A&M University, College Station, TX 77843, United States
Author contributions: Hayat Syed MK contributed to idea origination, literature review, write-up, and revision; Bruck O and Kumar A contributed to the literature review and write-up; Surani S contributed to idea origination, review, revision, and supervision.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, FCCP, MD, MHSc, Academic Editor, Professor, Department of Medicine and Pharmacology, Texas A&M University, 400 BIZZELL ST, College Station, TX 77843, United States. srsurani@hotmail.com
Received: February 27, 2023 Peer-review started: February 27, 2023 First decision: March 28, 2023 Revised: April 18, 2023 Accepted: May 17, 2023 Article in press: May 17, 2023 Published online: June 9, 2023 Processing time: 100 Days and 9.5 Hours
Abstract
Interstitial lung disease (ILD) is typically managed on an outpatient basis. Critical care physicians manage patients with ILD in the setting of an acute exacerbation (ILD flare) causing severe hypoxia. The principles of management of acute exacerbation of ILD are different from those used to manage patients with acute respiratory distress syndrome from sepsis, etc. Selected patients may be candidates for aggressive measures like extracorporeal membrane oxygenation and lung transplantation, while almost all patients will benefit from early palliative care. This review focused on the types of ILD, diagnosis, and management pathways for this challenging condition.
Core Tip: Interstitial lung disease (ILD) refers to a heterogeneous group of parenchymal lung disorders. Most patients with ILD receive management in outpatient clinics. Patients with acute exacerbation of ILD may experience significant respiratory distress, requiring urgent management in an intensive care unit. Timely diagnosis and management of these patients using a multimodality team approach may improve both morbidity and mortality. When acute exacerbation of ILD progresses to irreversible end-stage respiratory failure, lung transplantation and/or palliative care may be appropriate treatment options depending on the individual patient’s clinical presentation.
