期刊
RESPIRATION
卷 81, 期 2, 页码 107-117出版社
KARGER
DOI: 10.1159/000321958
关键词
Rapidly progressive interstitial pneumonia; Acute exacerbation; Polymyxin B direct hemoperfusion; Monocyte chemotactic protein 1; Arterial oxygen tension/inspiratory oxygen fraction ratio
资金
- national treasury of Japan
- Ministry of Health, Labour and Welfare, Japan
Background: Rapidly progressive interstitial pneumonia (IP), including acute exacerbation of IP, has a high mortality rate. Direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) was recently identified as an effective treatment for sepsis-associated acute respiratory distress syndrome. However, little is known about the effectiveness of PMX-DHP for rapidly progressive IP. Objectives: The present study investigates whether PMX-DHP is safe and effective against rapidly progressive IP. Methods: We retrospectively examined the effects of PMX-DHP in 33 consecutive patients with rapidly progressive IP who were resistant to steroid pulse therapy. Patients were hospitalized at Nagasaki University Hospital between 2006 and 2009. Results: Seventy-two hours after PMX-DHP, the arterial oxygen tension/inspiratory oxygen fraction ratio (median 127-153 mm Hg) had significantly improved. One week after PMX-DHP, the arterial oxygen tension/inspiratory oxygen fraction ratio (median 127-227 mm Hg), the alveolar-arterial difference of oxygen (median 371-177 mm Hg) and the number of positive criteria for systemic inflammatory response syndrome had significantly improved, despite the ineffectiveness of corticosteroid pulse therapy. The serum level of monocyte chemotactic protein 1 was significantly decreased immediately after PMX-DHP. Conclusions: PMX-DHP was safe and effective in improving oxygenation and systemic inflammatory response syndrome in patients with rapidly progressive IP. The beneficial effects of PMX-DHP may be at least partially due to the inhibition of monocyte activation. Copyright (C) 2010 S. Karger AG, Basel
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