title: Non-invasive mechanical ventilation in patients with diffuse interstitial lung diseases.
abstract: BACKGROUND
  To evaluate noninvasive ventilation (NIV) in diffuse interstitial lung diseases (DILD) patients with acute respiratory failure (ARF) according to baseline radiological patterns and the etiology of ARF.
  
  
  METHODS
  In a multicenter, observational, retrospective study, consecutive DILD patients undergoing NIV because of an episode of ARF were evaluated in six Italian high dependency units. Three groups of patients were identified based on the etiology of ARF: those with pneumonia (Group A), those with acute exacerbation of fibrosis, (Group B) and those with other triggers (Group C). Clinical failure was defined as any among in-hospital mortality, endotracheal intubation and extra-corporeal membrane oxygenation use.
  
  
  RESULTS
  Among the 60 patients enrolled (63% males; median age: 71 years), pneumonia (42%) and acute exacerbation of fibrosis (39%) were the two most frequent causes of ARF. A significant increase of PaO2/FiO2 ratio during NIV treatment was detected in Group A (p = 0.010), but not in Group B. No significant difference in PaO2/FiO2 ratio, PaCO2 and pH values during NIV treatment was detected in patients with a radiological pattern of usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP). 22 patients (37%) suffered for a clinical failure. No significant differences in the study outcome were detected in Group A vs. Group B, as well as among patients with a radiological pattern of UIP vs.
  NIV treatment should be individualized in DILD patients with ARF according to the etiology, but not the baseline radiological pattern, in order to improve oxygenation.
authors.affiliation: Department of Health Science, Clinica Pneumologica, AO San Gerardo, University of Milan Bicocca, Via Pergolesi 33, Monza, Italy. stefano.aliberti@unimib.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Aliberti
authors.forename: Grazia
authors.initials: G
authors.lastname: Messinesi
authors.forename: Silvia
authors.initials: S
authors.lastname: Gamberini
authors.forename: Sveva
authors.initials: S
authors.lastname: Maggiolini
authors.forename: Dina
authors.initials: D
authors.lastname: Visca
authors.forename: Vanni
authors.initials: V
authors.lastname: Galavotti
authors.forename: Fabio
authors.initials: F
authors.lastname: Giuliani
authors.forename: Roberto
authors.initials: R
authors.lastname: Cosentini
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Brambilla
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scala
authors.forename: Mauro
authors.initials: M
authors.lastname: Carone
authors.forename: Francesca
authors.initials: F
authors.lastname: Luisi
authors.forename: Sergio
authors.initials: S
authors.lastname: Harari
authors.forename: Antonio
authors.initials: A
authors.lastname: Voza
authors.forename: Antonio
authors.initials: A
authors.lastname: Esquinas
authors.forename: Alberto
authors.initials: A
authors.lastname: Pesci
mesh_terms: D000208:Acute Disease; D000368:Aged; D018549:Cryptogenic Organizing Pneumonia / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation; D010100:Oxygen; D010313:Partial Pressure; D011014:Pneumonia / Q000150:complications / Q000000981:diagnostic imaging; D011659:Pulmonary Gas Exchange; D011859:Radiography; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D010100:Oxygen