Acute exacerbations of interstitial lung diseases (AE-ILD): impact of an emergency action protocol

<bold>Introduction:</bold> AE-ILD have a significant impact on disease progression and quality of life. We developed an innovative approach in the diagnosis and treatment of suspected AE-ILD in the emergency department (ED) aimed to improve early identification and to optimize therapeutic interventions <bold>Methods:</bold> A diagnostic protocol was implemented for evaluation of patients with a previous diagnosis ILD presenting with respiratory symptoms or respiratory failure upon arrival at the ED. All patients with suspected AE-ILD underwent a high-resolution CT (HRCT) scan and CT angiography (CTA) upon arrival. Detailed follow-up of test results, treatment response and clinical evolution of each patient was recorded <bold>Results:</bold> 74 patients (51% male, age 74±7 years) with history of ILD who arrived at the emergency department between 2018 and 2022 were included in the protocol. 54% of patients showed new diffuse ground-glass opacities on the double technique CT scan, 20% showed no changes compared with previous studies, and 11% showed fibrotic progression. Pulmonary embolism was found in 7%. In-hospital mortality was 17.6%, and 30-day and one-year mortality were 18.9% and 45.9% <bold>Conclusions:</bold> The implementation of a diagnostic protocol for suspected AE-ILD which includes urgent HCRT and CTA in the emergency department is feasible. Rapid identification of AE-ILD allowed early and specific interventions, thereby contributing to reduced morbi-mortality <fig><object-id>erj;64/suppl_68/PA2450/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>