Title |
Treatment of acute exacerbation of idiopathic pulmonary fibrosis with direct hemoperfusion using a polymyxin B-immobilized fiber column improves survival
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Published in |
BMC Pulmonary Medicine, February 2015
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DOI | 10.1186/s12890-015-0004-4 |
Pubmed ID | |
Authors |
Noriyuki Enomoto, Masashi Mikamo, Yoshiyuki Oyama, Masato Kono, Dai Hashimoto, Tomoyuki Fujisawa, Naoki Inui, Yutaro Nakamura, Hideo Yasuda, Akihiko Kato, Soichiro Mimuro, Matsuyuki Doi, Shigehito Sato, Takafumi Suda |
Abstract |
Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) has an extremely poor prognosis and there is currently no effective treatment for this condition. Direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) improves oxygenation, but it is unclear whether treatment of AE-IPF with PMX-DHP affects survival. This study elucidated the effectiveness and safety of PMX-DHP for the treatment of AE-IPF. This study included 31 patients with 41 episodes of AE-IPF. All patients received steroids. Of 31, 14 patients (20 episodes) were treated with PMX-DHP. The laboratory and physiological test results after the start of therapy and survival were retrospectively compared between patients treated with and without PMX-DHP. Patients treated with PMX-DHP had a significantly greater change in PaO2/FiO2 ratio (mean ± SEM, 58.2 ± 22.5 vs. 0.7 ± 13.3, p = 0.034) and a smaller change in white blood cell count (-630 ± 959 /μL vs. 4500 ± 1190 /μL, p = 0.002) after 2 days of treatment than patients treated without PMX-DHP. The 12-month survival rate was significantly higher in patients treated with PMX-DHP (48.2% vs. 5.9%, p = 0.041). PMX-DHP was effective in patients with more severe underlying disease (GAP stages II or III; 12-month survival rate 57.1% with PMX-DHP vs. 0% without PMX-DHP, p = 0.021). Treatment with PMX-DHP was an independent predictor of better prognosis (hazard ratio 0.345, p = 0.037). Mild pulmonary thromboembolism occurred in one patient treated with PMX-DHP. Treatment of AE-IPF with PMX-DHP is tolerable and improves 12-month survival. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Israel | 1 | 20% |
Venezuela, Bolivarian Republic of | 1 | 20% |
United Kingdom | 1 | 20% |
Unknown | 2 | 40% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 4 | 80% |
Practitioners (doctors, other healthcare professionals) | 1 | 20% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 50 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 8 | 16% |
Other | 7 | 14% |
Student > Ph. D. Student | 7 | 14% |
Lecturer | 4 | 8% |
Professor > Associate Professor | 4 | 8% |
Other | 10 | 20% |
Unknown | 10 | 20% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 26 | 52% |
Agricultural and Biological Sciences | 4 | 8% |
Immunology and Microbiology | 3 | 6% |
Business, Management and Accounting | 1 | 2% |
Psychology | 1 | 2% |
Other | 1 | 2% |
Unknown | 14 | 28% |