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Mechanical Ventilation in Interstitial Lung Disease: Which Patients Are Likely to Benefit?

Ahmet Baydur, MD, FCCP
Author and Funding Information

Los Angeles, CA

Correspondence to: Ahmet Baydur, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Keck School of Medicine, University of Southern California, GNH 11-900, 2025 Zonal Avenue, Los Angeles, CA 90033; e-mail: baydur@usc.edu



Chest. 2008;133(5):1062-1063. doi:10.1378/chest.07-2615
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The chronic interstitial lung diseases (ILDs) have variable prognoses, ranging from death within a few weeks of diagnosis to recovery, depending on their rapidity of progression. In general, prognosis is judged on the basis of clinical, imaging, and pathologic features. The refinement of high-resolution CT scanning has facilitated the diagnosis of these conditions, so that in many cases, with experienced radiologic support, lung biopsies can be avoided. Correlative studies1 have strengthened the argument that those conditions that have a predominant cellular infiltration have better outcomes than those with a mainly fibrotic component. Patients with the latter form of disease (eg, idiopathic pulmonary fibrosis [IPF]) have the worst prognoses and succumb to their illness within 5 years of diagnosis. Those with a predominantly cellular component (eg, nonspecific interstitial pneumonia [NSIP]) respond variably to immunomodulatory therapy and either recover completely or at least have improved quality of life with a slower decline in lung function, unless they also have a fibrotic component to the disease.2

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