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Interstitial Pulmonary Fibrosis (Signs and Symptoms (increasing bouts of…
Interstitial Pulmonary Fibrosis
Pathophysiology
Hx of smoking / Agricultural exposure
Allergens
Environmental particles
breathing in spores from bacteria, mold and dust from hay
antigens in the lungs react with antibodies that circulate in the body generating a hypersensitive reaction - Farmer's Lung
White blood cells move into the lungs to attack antigens
Continued exposure (both duration and frequency) to allergens and environmental particles
causes immune system to prolong the inflammatory response
State of constant inflammation produces an environment rich in chemokines, pro-inflammatory, angiogenic, and fibrogenic cytokines, growth factors and tissue destructive enzymes
Increased extracellular matrix (fibrotic tissue) laid down, particularly in the alveoli due to swelling and inflammation throughout the lung
Elasticity in alveoli decreases resulting in inability of the alveoli to expand during inspiration and alveoli become less saturated with oxygen
Decreased oxygen exchange into the bloodstream resulting in decreased resting SpO2
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the body is unable to fully restore normal tissue architecture due to the continued inflammatory response and dysregulation of fibrotic lesions
Medical Management
Medications
Corticosteroids
Immunosuppressants
Pulmonary supplementation
O2 supplementation
when o2 demand is higher with increased activity
Pulmonary Vasodialator
Main treatment = avoidance of antigen/moldy dust
D/C with education on preventative measures
Develop new technique for drying hay
Increase airflow to confined spaces where antigens are present
Use of respiratory protective equipment to prevent antigens from entering lungs
Withdrawel from farming environment
Risk Factors
Second Hand Smoke Exposure
Environmental/Agricultural exposure: allergens could include: silica dust, asbestos fibers, grain dust, bird/animal droppings, radiation/chemo treatments, chemicals found in indoor hot tubs
moldy hay
age (risk increases with greater number of years of repeated exposure)
GERD
Family Hx
Signs and Symptoms
increasing bouts of shortness of breath
dyspnea upon exertion
dry irritating cough, crackles on auscultation
rapid breathing/HR
fever and chills, fatigue
feeling of sickness
loss of appetite/weight
aches and pains in muscles and joints, digital clubbing
Physical weakness
