So far, the studies of IPF patients in the ICU have had many limitations (Table 1) [4, 28, 29, 31, 32, 34, 59, 64] . Th ese studies are usually retrospective and single-centered and include limited numbers of patients. In addition, most of these studies include all IPF patients admitted to the ICU for respiratory failure regardless of etiology, the proportion of patients with confi rmed diagnosis is variable, the ventilator parameters are usually not reported, and the pharmacologic therapy demonstrates a signifi cant diversity. Th e only common parameter is the conclusion: the prognosis of ventilated IPF patients is disappointing [2] . Given these results, what may be the goals of ICU support for a patient with an IPF exacerbation? Although defi nite conclusions cannot be drawn, there is a general feeling that mechanical ventilation and intensive support do not have a signifi cant eff ect on outcome [2] . Could this be due to the disease itself, ventilator-induced lung injury, complications of intensive support (sepsis, critical care myoneuropathy, or ventilator-associated pneumonia), or a combination of the above? Only assumptions can be made, and patients (at an earlier stage) and relatives as well as physicians outside of the ICU before or at admission should become aware of the poor prognosis. Th is does not mean that IPF patients with acute respiratory failure should be denied admis sion; in many hospitals, the ICU is the right place to perform in a safe and timely fashion the necessary extended investigation to exclude reversible causes of deterioration in these patients.