title: Potential benefits of early continuous positive pressure ventilation in patients with rapidly progressive interstitial pneumonia.
abstract: OBJECTIVE
  Rapidly progressive interstitial pneumonia (RPIP), including acute exacerbations of interstitial pneumonia, is associated with high rates of mortality. The present study was performed to examine the effects of respiratory management using non-invasive ventilation (NIV) in patients with RPIP and to assess the prognostic factors for survival.
  
  
  METHODS
  BiPAP Vision was used for NIV. Clinical data and information on NIV were retrospectively obtained from patient records. Survival at 30 days was evaluated, and biomarkers were measured after initiation of NIV.
  
  
  RESULTS
  Thirty-eight patients who had been admitted with RPIP and treated by NIV were included in the study. The ratio of PaO(2) to fraction of inspired oxygen at initiation of NIV was higher in survivors than in non-survivors (P = 0.0054). The mean duration to initiation of NIV after admission was significantly shorter in survivors than in non-survivors (P = 0.0006). Serum Krebs von den Lungen-6 (KL-6) and LDH levels at the start of NIV were higher in non-survivors than in survivors (KL-6, P = 0.022; LDH, P = 0.044). Bivariate logistic regression analysis showed that early intervention with NIV was a significant predictor of survival at 30 days. In addition, the ratio of PaO(2) to fraction of inspired oxygen and both LDH and KL-6 levels at initiation of NIV were significant predictors of survival.
  
  
  CONCLUSIONS
  Early intervention with NIV, mainly continuous positive pressure ventilation, is beneficial for the management of patients with RPIP. A randomized controlled study in a large population is needed to confirm the value of early NIV.
authors: First Department of Internal Medicine, Shinshu University School of Medicine, Nagano, Japan.
authors: Toshiki
authors: T
authors: Yokoyama
authors: Kenji
authors: K
authors: Tsushima
authors: Hiroshi
authors: H
authors: Yamamoto
authors: Tomonobu
authors: T
authors: Koizumi
authors: Keishi
authors: K
authors: Kubo
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017563:Lung Diseases, Interstitial / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D008297:Male; D018396:Mucin-1 / Q000097:blood; D010101:Oxygen Consumption; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1