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Noninvasive Oxygenation Strategies For Acute Exacerbation of Interstitial Lung Disease

A Retrospective Single-center Study and a Review of the Literature

Imai, Ryosuke MD*; Tsugitomi, Ryosuke MD*; Nakaoka, Hiroshi MD; Jinta, Torahiko MD, PhD*; Tamura, Tomohide MD*

Clinical Pulmonary Medicine: May 2019 - Volume 26 - Issue 3 - p 87–91
doi: 10.1097/CPM.0000000000000312
Interstitial, Inflammatory & Occupational Lung Disease

Acute exacerbation of interstitial lung disease (AE-ILD) causes severe respiratory failure so that the patients would often require mechanical ventilation. Mechanical ventilation may improve survival in selected patients with AE-ILD; however, in-hospital mortality rate is so high in patients who need mechanical ventilation that the use of mechanical ventilation is weakly recommended. Although there is no fixed strategy with regard to selection of oxygen devices, a palliative approach to how to spend the end-of-life periods is often needed. Although noninvasive ventilation may be used to avoid intubation, high-flow nasal cannula (HFNC) was developed in recent years and has been feasible and useful for acute respiratory failure of various causes. In terms of the quality of life, moreover, HFNC systems are associated with patient comfort and tolerance and more ability for oral intake of nutrition and less occurrence of cognitive dysfunction or coma. HFNC has broad utility, and it is likely that usage will increase more and more in the future. Limited data of its use in AE-ILD are available, and further study will be necessary.

*Department of Pulmonary Medicine, Thoracic Center, St. Luke’s International Hospital, Tokyo

Department of Respiratory Medicine, Chikamori Hospital, Kochi, Japan

R.I.: designed the study, reviewed and analyzed data, interpreted results, and prepared the manuscript. R.T. and T.J.: contributed to the study design, data analysis, and interpretation of results. R.I., R.T., H.N., T.J., and T.T.: approved the final version of the manuscript.

Disclosure: The authors declare that they have no conflicts of interest.

Address correspondence to: Ryosuke Imai, MD, Department of Pulmonary Medicine, Thoracic Center, St. Luke’s International Hospital, 9-1, Akashi-cho, Chuo City, Tokyo 104-8560, Japan. E-mail:

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