Acute exacerbations in patients with idiopathic pulmonary fibrosis

Respiratory Research

Table 1 Diagnostic criteria for AEx-IPF

1	Previous or concurrent diagnosis of IPF^†
2	Unexplained worsening or development of dyspnea within 30 days
3	HRCT with new bilateral ground-glass abnormality and/or consolidation superimposed on a background reticular or honeycomb pattern consistent with UIP pattern^‡
4	No evidence of pulmonary infection by endotracheal aspirate or BAL^§
5	Exclusion of alternative causes, including:
	• Left heart failure
	• Pulmonary embolism
	• Identifiable cause of acute lung injury^¶

^†If the diagnosis of IPF is not previously established according to American Thoracic Society/European Respiratory Society consensus criteria, this criterion can be met by the presence of radiologic and/or histopathologic changes consistent with UIP pattern on the current evaluation. ^‡If no previous HRCT is available, the qualifier “new” can be dropped. ^§Evaluation of samples should include studies for routine bacterial organisms, opportunistic pathogens, and common viral pathogens. ^¶Causes of acute lung injury include sepsis, aspiration, trauma, reperfusion pulmonary edema, pulmonary contusion, fat embolization, inhalational injury, cardiopulmonary bypass, drug toxicity, acute pancreatitis, transfusion of blood products, and stem cell transplantation.
Reproduced from Collard HR, et al.: Acute exacerbations of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2007, 176:636–643. Reprinted with permission of the American Thoracic Society. Copyright © 2013 American Thoracic Society.

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