Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is an often deadly complication of IPF. No focussed international guidelines for the management of AE-IPF exist. The aim of this international survey was to assess the global variability in prevention, diagnostic and treatment strategies for AE-IPF.Pulmonologists with ILD expertise were invited to participate in a survey designed by an international expert panel.509 pulmonologists from 66 countries responded. Significant geographical variability in approaches to manage AE-IPF was found. Common preventive measures included antifibrotic drugs and vaccination. Diagnostic differences were most pronounced regarding use of Krebs von den Lungen-6 and viral testing, while high-resolution computed tomography, brain natriuretic peptide and D-dimer are generally applied. High-dose steroids are widely administered (94%); the use of other immunosuppressant and treatment strategies is highly variable. Very few (4%) responders never use immunosuppression. Antifibrotic treatments are initiated during AE-IPF by 67%. Invasive ventilation or extracorporeal membrane oxygenation are mainly used as a bridge to transplantation. Most physicians educate patients comprehensively on the severity of AE-IPF (82%) and consider palliative care (64%).Approaches to the prevention, diagnosis and treatment of AE-IPF vary worldwide. Global trials and guidelines to improve the prognosis of AE-IPF are needed.

Currently, chronic obstructive pulmonary disease (COPD) is a global health issue and one of the leading causes of death in the world. COPD therapy includes pharmacological and non-pharmacological approaches that can significantly improve clinical symptoms and reduce frequency of exacerbations of the disease.Methodology. The target audience of these clinical recommendations are therapists, general practitioners, and pulmonologists. Each thesis-recommendation about diagnostic and therapeutic procedures was graded according to the scales of classes of recommendations from 1 to 5 and the A, B, C scale of the levels of evidence. The clinical recommendations also contain comments and explanations to the theses together with algorithms for the diagnosis and treatment of COPD.Conclusion. The presented clinical guidelines cover the latest information about the etiology and pathogenesis, clinical manifestations, diagnosis, treatment, and prevention of chronic obstructive pulmonary disease. These guidelines were approved by the Scientific and Practical Council of the Ministry of Health of the Russian Federation in 2021.

Spirometry is the most common method to assess respiratory function. It is widely used to obtain objective information for the diagnosis of respiratory diseases and monitoring the functional state of the respiratory system. In 2014, the Russian Respiratory Society approved the technical standards for performing spirometry. Improvements in measuring devices have necessitated updating technical standards and standardizing the result interpretation algorithm.Methods. This document on spirometry was prepared by a joint group of experts from the Russian Respiratory Society and the Russian Association of Specialists in Functional Diagnostics, who have experience in performing spirometry in accordance with quality criteria, analyzing the results of the study, and developing national standards.Results. The 2014 Spirometry Technical Standards were revised, including the addition of quality criteria for measurements and test quality assessment. Where necessary, evidence was provided to support the change. The experience and knowledge of the expert group members were used to develop these recommendations.Conclusion. Standards for spirometry and bronchodilator test and the result interpretation algorithm are presented to improve the measurement quality and consistency of data interpretation.