Beneficial effect of polymyxin B-immobilized fiber column (PMX) hemoperfusion treatment on acute exacerbation of idiopathic pulmonary fibrosis.
OBJECTIVE
This study was aimed to investigate the effect of polymyxin B-immobilized fiber column (PMX) hemoperfusion treatment on the acute exacerbation of idiopathic pulmonary fibrosis (IPF).


METHODS
Six patients with a clinical diagnosis of idiopathic pulmonary fibrosis (IPF) who developed acute exacerbation were included in this study. Although five of six patients were treated with high-dose corticosteroid therapy, mechanical ventilation was necessary for all six patients due to severe respiratory failure. Blood endotoxin levels were undetectable in all patients. PMX treatment was performed on these six patients.


RESULTS
In four of six patients, alveolar-arterial difference of oxygen (AaDO(2)), serum KL-6 and lactate dehydrogenase (LDH) were improved after PMX treatment. These four patients were successfully weaned from mechanical ventilation and survived more than 30 days after the initial PMX treatment.


CONCLUSIONS
These data suggest a potential beneficial effect of PMX treatment on acute exacerbation of IPF.
Seo
Yoshitsugu
Y
4th Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-8603, Japan.
Abe
Shinji
S
Kurahara
Misuzu
M
Okada
Daisuke
D
Saito
Yoshinobu
Y
Usuki
Jiro
J
Azuma
Arata
A
Koizumi
Kiyoshi
K
Kudoh
Shoji
S
D000208:Acute Disease; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins / Q000097:blood; D010100:Oxygen / Q000032:analysis; D010865:Pilot Projects; D011112:Polymyxin B / Q000008:administration & dosage*; D011658:Pulmonary Fibrosis / Q000188:drug therapy* / Q000628:therapy; D012121:Respiration, Artificial; D016019:Survival Analysis; D016896:Treatment Outcome
D000951:Antigens, Neoplasm; D005938:Glucocorticoids; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins; D007770:L-Lactate Dehydrogenase; D011112:Polymyxin B; D010100:Oxygen