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Management of Chronic Respiratory Failure in Interstitial Lung Diseases: Overview and Clinical Insights
- Source :
- International Journal of Medical Sciences
- Publication Year :
- 2019
-
Abstract
- Interstitial lung diseases (ILDs) may be complicated by chronic respiratory failure (CRF), especially in the advanced stages. Aim of this narrative review is to evaluate the current evidence in management of CRF in ILDs. Many physiological mechanisms underlie CRF in ILDs, including lung restriction, ventilation/perfusion mismatch, impaired diffusion capacity and pulmonary vascular damage. Intermittent exertional hypoxemia is often the initial sign of CRF, evolving, as ILD progresses, into continuous hypoxemia. In the majority of the cases, the development of CRF is secondary to the worsening of the underlying disease; however, associated comorbidities may also play a role. When managing CRF in ILDs, the need for pulmonary rehabilitation, the referral to lung transplant centers and palliative care should be assessed and, if necessary, promptly offered. Long-term oxygen therapy is commonly prescribed in case of resting or exertional hypoxemia with the purpose to decrease dyspnea and improve exercise tolerance. High-Flow Nasal Cannula oxygen therapy may be used as an alternative to conventional oxygen therapy for ILD patients with severe hypoxemia requiring both high flows and high oxygen concentrations. Non-Invasive Ventilation may be used in the chronic setting for palliation of end-stage ILD patients, although the evidence to support this application is very limited.
- Subjects :
- medicine.medical_specialty
Palliative care
Interstitial lung diseases
medicine.medical_treatment
Interstitial lung disease
Review
oxygen therapy
medicine.disease_cause
Hypoxemia
03 medical and health sciences
Idiopathic pulmonary fibrosis
0302 clinical medicine
Oxygen therapy
medicine
Humans
Pulmonary rehabilitation
chronic respiratory failure
Intensive care medicine
Hypoxia
Lung
idiopathic pulmonary fibrosi
business.industry
non-invasive ventilation
Palliative Care
Oxygen Inhalation Therapy
General Medicine
respiratory system
medicine.disease
idiopathic pulmonary fibrosis
respiratory tract diseases
Oxygen
medicine.anatomical_structure
Treatment Outcome
Chronic Disease
Breathing
Disease Progression
030211 gastroenterology & hepatology
medicine.symptom
business
Lung Diseases, Interstitial
Respiratory Insufficiency
Nasal cannula
Lung Transplantation
Subjects
Details
- ISSN :
- 14491907
- Volume :
- 16
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- International journal of medical sciences
- Accession number :
- edsair.doi.dedup.....03cb3bc7263ad4ddacd386754a46f6e7