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Comorbidities, Complications and Non-Pharmacologic Treatment in Idiopathic Pulmonary Fibrosis

机译:特发性肺纤维化的合并症,并发症和非药物治疗

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Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and fatal disease. The treatment is challenging and nowadays a comprehensive approach based not only in pharmacological strategies is necessary. Identification and control of comorbidities, non-pharmacological treatment, prevention and management of exacerbations as well as other areas of care (social, psychological) are fundamental for a holistic management of IPF. Gastroesophageal reflux, pulmonary hypertension, obstructive sleep apnea, combined with emphysema, lung cancer and cardiovascular involvement are the main comorbidities associated with IPF. Non-pharmacological treatment includes the use of oxygen in patients with rest or nocturnal hypoxemia and other support therapies such as non-invasive ventilation or even a high-flow nasal cannula to improve dyspnea. In some patients, lung transplant should be considered as this enhances survival. Pulmonary rehabilitation can add benefits in outcomes such control of dyspnea, exercise capacity distance and, overall, improve the quality of life; therefore it should be considered in patients with IPF. Also, multidisciplinary palliative care programs could help with symptom control and psychological support, with the aim of maintaining quality of life during the whole process of the disease. This review intends to provide clear information to help those involved in IPF follow up to improve patients’ daily care.
机译:特发性肺纤维化(IPF)是一种慢性,进行性和致命性疾病。治疗具有挑战性,如今,不仅基于药理学策略的综合方法是必要的。合并症的识别和控制,非药物治疗,加重的预防和管理以及其他护理领域(社会,心理)是IPF整体管理的基础。胃食管反流,肺动脉高压,阻塞性睡眠呼吸暂停,肺气肿,肺癌和心血管受累是与IPF相关的主要合并症。非药物治疗包括在患有休息或夜间低氧血症的患者中使用氧气,以及其他支持疗法,例如无创通气甚至是高流量鼻导管,以改善呼吸困难。在某些患者中,应考虑进行肺移植,因为这可以提高生存率。肺部康复可以增加诸如呼吸困难,运动能力距离控制等结果,并总体上改善生活质量;因此在IPF患者中应考虑使用。此外,多学科姑息治疗计划可以帮助控制症状和提供心理支持,目的是在疾病的整个过程中维持生活质量。这篇综述旨在提供明确的信息,以帮助那些参与IPF的人员跟进以改善患者的日常护理。

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