Postoperative Acute Exacerbation of IPF after Lung Resection for Primary Lung Cancer

Table 1

Definition of acute exacerbation of IPF described by Hyzy et al. [10].

Previous or concurrent diagnosis of IPF*
Unexplained worsening or development of dyspnea within 30 d
High-resolution CT scan with new bilateral ground-glass abnormality and/or consolidation superimposed on a background reticular or honeycomb pattern consistent with a UIP pattern^†
Worsening hypoxemia from a known baseline arterial blood gas^‡
No evidence of pulmonary infection by endotracheal aspiration or BAL
Exclusion of alternative causes, including
left heart failure
pulmonary embolism
identifiable cause of acute lung injury^§

*This criterion can be met by the presence of radiologic and/or histopathologic changes consistent with a UIP pattern if a diagnosis of IPF has not been previously established by American Thoracic Society/European Respiratory Society criteria.
^†Current high-resolution CT scan is acceptable without prior high-resolution CT scan for comparison if none is available.
^‡Includes evaluation for common bacterial organisms and viral pathogens.
^§Causes of lung injury include sepsis, aspiration, trauma, transfusion of blood products, pulmonary contusion, fat embolization, drug toxicity, acute pancreatitis, inhalational injury, and cardiopulmonary bypass.