What are the next steps in the management of a patient admitted with an IPF exacerbation resistant to steroid therapy?

IPF exacerbation is associated with a poor prognosis, with an in-hospital mortality rate of up to 50% in one study (Song et al., PMID 20595144). As discussed earlier by Dr. @Dr. First Last, there are currently no established or evidence-based pharmacotherapies for managing IPF exacerbation. Aggressi...

Really not much you can do. Some discussion:

The typical "search for alternative diagnoses" (e.g. PE, viral infection) sometimes is fruitful, but the overall prognosis in an IPF exacerbation is poor.

Party line answer is to provide more immune suppression, but I think it's becoming glaringly obvious t...