TY - JOUR T1 - Ethical issues in idiopathic pulmonary fibrosis with acute respiratory failure (IPF-ARF): An Italian survey JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - 2973 AU - Raffaele Scala AU - Stefano Nava AU - Antonio Corrado AU - Marco Confalonieri AU - Nicola Facciolongo Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/2973.abstract N2 - Aims: To determine Italian Pulmonologist's attitudes and behaviour towards diagnostic and therapeutical choices in competent IPF-ARF patients.Methods: A web-site survey (30-items questionnaire) was sent to all the members of the Study Groups of Respiratory Intensive Care and Diffuse Lung Diseases of Italian Association of Italian Pulmonologists (January-March 2009).Results: 248/370 (67%) physicians responded to the questionnaire (>60%:over-fifties, male, Catholics).About 75% of respondents agreed on having anticipated directives and on eventually communicating bad news about IPF-ARF.>75% of respondents answered that any diagnostic (BAL and/or TBB) and therapeutical choices (drugs,ventilation,palliative care) should be discussed with the patients and relatives. However, almost 50% of respondents reported to start ventilation and palliative care only in <25% of cases.BAL under NIV was recommended to eventually find the cause of ARF by half of respondents, while 77% reported to perform BAL and/or TBB in <25% of cases.More responders stated that NIV was not likely to improve survival (76.7% vs 10.0%) and to facilitate the communication with the relatives (50.7% vs 19.4%). 43.5% of the physicians did not agree on the concept of using NIV to reduce dyspnea and 40% on its use to gain time for end-of-life decisions. >60% of the respondents considered to perform NIV and intubation when a reversible ARF cause is supposed.About 60% of the respondents used NIV and palliation in <25% of cases, while >90% of them intubated patients in <25% of cases.Conclusions: A discrepancy between attitudes and behaviour of Italian Pulmonologists emerged towards IPF-ARF issues. ER -