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Pulmonary Fibrosis

End or late-stage IPF

06/12/2009

Question:

My father is 84 and was diagnosed 3 years ago. He has begun to fall frequently and can`t walk more than 10 steps without stopping and gasping for air. At rest is o2 sat is 96% on 5lpm. With any exertion his sats drop to 80 or less. He has begun to exhibit short term memory loss and confusion. Is this typical in the later stages of this disease? Is the falling also expected? If his sats are not that low, why does he gasp for air? Thank you so much.

Answer:

Short-term memory loss and confusion can be a result of late-stage pulmonary fibrosis either because of a persistently low oxygen level, because of a high carbon dioxide level, or as a side effect of medications. Any of these 3 factors can also result in falling.

The air hunger (gasping for air) can be due to either the oxygen level falling below 90% or due to the lungs becoming more constricted so that a person does not feel he or she is able to get a full breath. In this situation, hospice can be particularly valuable to help review the medications, ensure that he is on the best medications to relieve air hunger, and evaluate the home for safety measures that can reduce the chances of falling and injury.

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Response by:

James N Allen, Jr, MD James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University