Abstract
Background
Interstitial lung disease (ILD) is a group of restrictive pulmonary diseases associated
with diffuse interstitial and parenchymal inflammation. Patients can present to the
emergency department with severe exacerbation.
Objective
This narrative review provides emergency clinicians with the most recent evidence
concerning acute exacerbation of ILD (AE-ILD).
Discussion
AE-ILD can present as acute respiratory distress in a patient with a pre-existing
ILD diagnosis or as a de novo presentation of ILD, and is associated with significant
morbidity and mortality. A variety of underlying triggers may result in AE-ILD. Emergency
clinicians must first assess for extraneous causes of respiratory decompensation prior
to diagnosing AE-ILD. For a de novo presentation of ILD, emergency physicians should
also assess for possible reversible causes. AE-ILD is managed with systemic steroids,
immunosuppressants, intravenous antibiotics, supplemental oxygen, and extracorporeal
membrane oxygenation in severe cases. Given the high mortality rates in the absence
of lung transplantation, early referral to transplant centers is essential to increase
chances of survival.
Conclusions
Emergency clinician knowledge of AE-ILD can improve the evaluation and management
of these patients.
Keywords
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Article info
Publication history
Published online: October 31, 2022
Accepted:
October 21,
2022
Received in revised form:
October 5,
2022
Received:
May 31,
2022
Footnotes
This review does not reflect the views or opinions of the U.S. government, Department of Defense, U.S. Army, U.S. Air Force, or SAUSHEC EM Residency Program.
Identification
Copyright
Published by Elsevier Inc.
