title: A pilot study: a combined therapy using polymyxin-B hemoperfusion and extracorporeal membrane oxygenation for acute exacerbation of interstitial pneumonia.
abstract: BACKGROUND
  Direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) might be beneficial for treating acute exacerbation (AE) of interstitial pneumonia (IP). Venovenous extracorporeal membranous oxygenation (VV-ECMO) is an emerging tool to avoid ventilator-induced lung injury. This is a report presenting the first three patients with AE of IP treated with a combined therapy of PMX-DHP and VV-ECMO.
  
  
  METHODS
  Patient 1 was a 68-year-old male with acute interstitial pneumonia, patient 2 a 67-year-old male with AE of idiopathic pulmonary fibrosis, and patient 3 a 61-year-old female with AE of collagen vascular disease-associated interstitial pneumonia. All patients were severely hypoxemic and required mechanical ventilation. A combined therapy using PMX-DHP and VV-ECMO was initiated with support of intravenous corticosteroids and antibiotics. Radiological findings, oxygenation and laboratory findings markedly improved and all patients survived without severe complications.
  
  
  CONCLUSIONS
  A combined therapy of PMX-DHP and VV-ECMO might be a therapeutic option for AE of IP.
authors.affiliation: . jitai@hiroshima-u.ac.jp.
authors.forename: Junji
authors.initials: J
authors.lastname: Itai
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Ohshimo
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kida
authors.forename: Kohei
authors.initials: K
authors.lastname: Ota
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hirohashi
authors.forename: Francesco
authors.initials: F
authors.lastname: Bonella
authors.forename: Josune
authors.initials: J
authors.lastname: Guzman
authors.forename: Ulrich
authors.initials: U
authors.lastname: Costabel
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Kohno
authors.forename: Koichi
authors.initials: K
authors.lastname: Tanigawa
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D018450:Disease Progression; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis / Q000628:therapy*; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011112:Polymyxin B / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D011112:Polymyxin B