[Causes of respiratory failure complicating interstitial lung disease and application value of mechanical ventilation]

Abstract

Objective: To investigate the potential causes of respiratory failure in patients with interstitial lung disease (ILD) and evaluate the application value of mechanical ventilation (MV) in its treatment.

Methods: This study included the clinical data of 47 ILD patients (29 males and 18 females) complicating respiratory failure and admitted to respiratory care unit (RICU) for receiving MV at Beijing Chaoyang Hospital from January 1, 1998 to June 30, 2008. The median age was 67 years old. And a retrospective analysis was conducted for clinical characteristics, potential causes of respiratory failure, RICU treatment, prognosis and causes of death, etc.

Results: The causes of respiratory failure were as follows: respiratory infections (n = 18, 38.3%), respiratory infection superimposed aggravated ILD (n = 15, 31.9%), pulmonary embolism (n = 8, 17.0%), ILD with acute exacerbation (n = 5, 10.6%) and heart failure (n = 1, 2.1%). And the mortality rates of RICU were 55.6% (10/18), 73.3% (11/15), 5/8, 4/5 and 1/1 respectively. Upon initial admission into RICU, 31 cases received noninvasive ventilation and 16 cases tracheal intubation. The mortality rates were 54.8% and 87.5% respectively. And there was statistically significant difference between the groups (chi(2) = 5.014, P = 0.025). In all patients, the RICU mortality rate was 66.0% (31/47) and the hospital mortality rate 70.2% (33/47).

Conclusions: Respiratory infection, pulmonary embolism and acute exacerbation of ILD are the main common causes of respiratory failure in ILD patients. Noninvasive ventilation therapy is clinically preferable to invasive ventilation for ILD patients with respiratory failure.