Table 2.

Management considerations for acute exacerbation of IPF

Intervention	Recommendation
Prevention of acute exacerbation of IPF
Influenzae and pneumococcal vaccination	+
Hand washing, avoidance of sick contacts	+
Behavioral modifications for reflux and aspiration	+
Proton pump inhibitor therapy	+/−
Minimization of mechanical stress during surgery	+
Avoidance of airborne irritants and pollutants	+/−
Treatment of acute exacerbation of IPF
Mechanical ventilation	+/−
Corticosteroids	+
Empiric antibiotics	+
Other therapies (tacrolimus, polymixin B hemoperfusion, cyclosporine A, thrombomodulin)	−
Pharmacological therapies for idiopathic pulmonary fibrosis	+/−
Lung transplantation	+/−

+ = Would consider using in most patients as potential benefit seems to outweigh potential harm; +/− = Would consider using in selected cases as the balance of benefit and risk varies by clinical situation; − = Would not consider using in most patients as evidence is lacking to support a clinical benefit. Abbreviations: IPF = idiopathic pulmonary fibrosis.