Skip to main content

Outcome of patients with interstitial lung diseases admitted to the Respiratory Intensive Care Unit



Clinicians may face unique challenges while managing critically ill patients with interstitial lung diseases (ILD) admitted to respiratory intensive care units (RICUs).


The aim of the present study was to determine the outcome of ILD patients admitted to RICU as regards mortality rate and risk factors associated with mortality.

Patients and methods

Ninety-one patients with ILD admitted to RICU were prospectively recruited. We analyzed demographic data, pulmonary function test results, arterial blood gas values, therapeutic strategies, mechanical ventilation (MV) use, RICU and hospital duration, and mortality rates.


The RICU morality rate was 9.9%. Presence of hemophilia, renal impairment, low-diffusion lung capacity for carbon monoxide, and low arterial oxygen saturation were significantly more frequent among nonsurvivor compared with survivor patients. All nonsurvivor patients had pulmonary hypertension compared with 69% of the survivors, but without a significant difference. Fifteen percent of our patients received invasive MV. There were no significant differences between nonsurvivors and survivors as regards need for MV and duration of MV. Whereas patients with a positive history of previous MV had a significant survival time that was less than those with a negative history of previous MV. The duration of hospital and RICU stay were significantly longer in the survivors group compared with the nonsurvivors group (12.65±9.06 vs. 5.55±4.12 and 10.51±7.51 vs. 4.88±2.31, respectively).


Our study population showed very low RICU morality rate when compared with previous studies. Nonsurvivors had a shorter hospital and RICU stay, positive history of previous MV, lower diffusion lung capacity for carbon monoxide, and lower arterial oxygen saturation.


  1. Schwarz M, King T. Interstitial lung diseases. Hamilton: B.C. Decker; 1998.

  2. American Thoracic Society/European Respiratory Society. International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2002; 165:277–304.

    Article  Google Scholar 

  3. Antoniou K, Margaritopoulos G, Tomassetti S, Bonella F, Costabel U, Poletti V. Interstitial lung disease. Eur Respir Rev 2014; 23:40–54.

    Article  Google Scholar 

  4. Xaubet A, Molina-Molina M, Badia J, Torres A. Outcome of patients with Interstitial lung diseases requiring mechanical ventilation. Clin Pulm Med 2005; 12:26–31.

    Article  Google Scholar 

  5. Disayabutr S, Calfee C, Collard H, Wolters P. Interstitial lung diseases in the hospitalized patient. BMC Medicine 2015; 13:245.

    Article  Google Scholar 

  6. Güngör G, Tatar D, Saltürk C, Çimen P, Karakurt Z, Kirakli C. Why do patients with interstitial lung diseases fail in the ICU? A 2-center cohort study. Respir Care 2013; 58:525–531.

    Article  Google Scholar 

  7. Zafrani L, Lemiale V, Lapidus N, Lorillon G, Schlemmer B, Azoulay E. Acute respiratory failure in critically ill patients with interstitial lung disease. PLoS One 2014; 9:e104897.

    Article  Google Scholar 

  8. Raghu G, Collard H, Egan J, Martinez F, Behr J, Brown K. An official ATS/ ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011; 183:788–824.

    Article  Google Scholar 

  9. Wells A, Hirani N. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax 2008; 63(Suppl V): v1–v58.

  10. Statement on Sarcoidosis. Joint statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and other Granulomatous Disorders (WASOG). Am J Respir Crit Care Med 1999; 160:736–755.

    Article  Google Scholar 

  11. Fischer A, du Bois R. Interstitial lung disease in connective tissue disorders. Lancet 2012; 380:689–698.

    Article  Google Scholar 

  12. Bhatt N, Allen J. Update on eosinophilic lung diseases. Semin Respir Crit Care Med 2012? 33:555–571.

  13. Johnson S, Cordier J, Lazor R, Cottin V, Costabel U, Harari S. European Respiratory Society guidelines for the diagnosis and management of lymphangioleiomyomatosis. Eur Respir J 2010; 35:14–26.

    CAS  Article  Google Scholar 

  14. American Thoracic Society, European Respiratory Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International Consensus Statement. Am J Respir Crit Care Med 2000; 161(Part 1):646–664.

  15. Kondoh Y, Taniguchi H, Kawabata Y. Acute exacerbation in idiopathic pulmonary fibrosis: analysis of clinical and pathologic findings in three cases. Chest 1993; 103:1808–1812.

    CAS  Article  Google Scholar 

  16. Akira M, Hamada H, Sakatani M. CT findings during phase of accelerated deterioration in patients with idiopathic pulmonary fibrosis. Am J Roentgenol 1997; 168:79–83.

    CAS  Article  Google Scholar 

  17. Collard H, Moore B, Flaherty K, Brown K, Kaner R, King T. Acute exacerbations of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2007; 176:636–643.

    Article  Google Scholar 

  18. Papanikolaou I, Drakopanagiotakis F, Polychronopoulos V. Acute exacerbations of interstitial lung diseases. Curr Opin Pulm Med 2010; 16: 480–486.

    Article  Google Scholar 

  19. Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean N. Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis 2007; 44(Suppl 2):S27–S72.

  20. American Thoracic Society; Infectious Diseases Society of America. Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005; 171:388–416.

    Article  Google Scholar 

  21. Fernández-Pérez E, Yilmaz M, Jenad H, Daniels C, Ryu JH, Hubma R, Gajic O. Ventilator settings and outcome of respiratory failure in chronic interstitial lung disease. Chest 2008; 133:1113–1119.

    Article  Google Scholar 

  22. Vial-Dupuy A, Sanchez O, Douvry B, Guetta L, Juvin K, Wermert D. Outcome of patients with interstitial lung disease admitted to the intensive care unit. Sarcoidosis Vasc Diffuse Lung Dis 2013; 30:134–142.

    CAS  PubMed  Google Scholar 

  23. Park N, Kim D, Shim T, Lim C, Lee S, Koh Y. Acute exacerbation of interstitial pneumonia other than idiopathicpulmonary fibrosis. Chest 2007; 132:214–220.

    Article  Google Scholar 

  24. Saydain G, Islam A, Afessa B, Ryu J, Scott J, Peters S. Outcome of patients with idiopathic pulmonary fibrosis admitted to the intensive care unit. Am J Respir Crit Care Med 2002; 166:839–842.

    Article  Google Scholar 

  25. Blivet S, Philit F, Sab J, Langevin B, Paret M, Guérin C. Outcome of patients with idiopathic pulmonary fibrosis admitted to the ICU for respiratory failure. Chest 2001; 120:209–212.

    CAS  Article  Google Scholar 

  26. Rangappa P, Moran JL. Outcomes of patients admitted to the intensive care unit with idiopathic pulmonary fibrosis. Crit Care Resusc 2009; 11:102–109.

    PubMed  Google Scholar 

  27. Song J, Hong S, Lim C-M, Koh Y, Kim D. Acute exacerbation of idiopathicpulmonary fibrosis: incidence, risk factors and outcome. Eur Respir J 2011; 37:356–363.

    CAS  Article  Google Scholar 

  28. Nava S, Rubini F. Lung and chest wall mechanics in ventilated patients with end stage idiopathic pulmonary fibrosis. Thorax 1999; 54:390–395.

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Nehad M. Osman MD, PhD.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Osman, N.M., Sharkawy, S.H. & Gomaa, A.A. Outcome of patients with interstitial lung diseases admitted to the Respiratory Intensive Care Unit. Egypt J Bronchol 11, 134–140 (2017).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • interstitial lung diseases patients
  • mortality rate
  • risk factors