Diagnosis and Management of Acute Exacerbation of Interstitial Lung Disease in the Intensive Care Unit

Interstitial lung disease is a complex radiographic and histologic diagnosis, encompassing more than 200 disorders. Acute exacerbation presents as acute respiratory failure and mimics an upper respiratory viral syndrome. An extensive diagnostic workup is required to rule out other causes of acute respiratory failure and identify potential triggers. Treatment, including general supportive care and immunosuppression, depends on the underlying pathology. Respiratory support with high-flow nasal cannula should be initiated early in an attempt to minimize progression to invasive mechanical ventilation. Multidisciplinary conversations are vital to establish a care plan and outline candidacy for invasive mechanical ventilation, extracorporeal life support, and transplantation.