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Prognostic factors analysis of patients with acute exacerbation of idiopathic interstitial pneumonias treated by polymyxin B hemoperfusion

Keiji Oishi, Keisuke Aoe, Yoriyuki Murata, Kenji Sakamoto, Takashi Ohfuji, Wataru Kotoku, Yoshiko Ogata, Tsuneo Matsumoto, Hiroshi Ueoka, Yusuke Mimura
European Respiratory Journal 2013 42: P462; DOI:
Keiji Oishi
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
2Clinical Research, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Keisuke Aoe
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
2Clinical Research, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Yoriyuki Murata
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
2Clinical Research, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Kenji Sakamoto
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Takashi Ohfuji
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Wataru Kotoku
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Yoshiko Ogata
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Tsuneo Matsumoto
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Hiroshi Ueoka
1Respiratory Medicine, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Yusuke Mimura
2Clinical Research, NHO Yamaguchi-Ube Medical Center, Ube, Japan
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Abstract

Background: Acute exacerbations of idiopathic interstitial pneumonias (AE-IIPs) are episodes of acute respiratory worsening with high mortality. Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP), which was established in Japan for treatment of sepsis, has been shown to improve the respiratory status of patients with ARDS. Recent reports have suggested beneficial effects of PMX-DHP on oxygenation in AE-IIPs as well. Here we aimed to investigate the outcome and prognostic factors in patients with AE-IIPs treated by PMX-DHP.

Methods: We retrospectively compared 23 AE-IIP patients treated by steroid pulse therapy and PMX-DHP (PMX-DHP group) with 16 AE-IIP patients by steroid pulse therapy (control group). PMX-DHP was conducted once daily for 6 hours, 2 successive days.

Results: The 90-day survival rate was significantly higher in PMX-DHP group (52.2%) than in control group (18.8%). The median survival time was 192 days for PMX-DHP group vs 21.5 days for control group (log rank test P value = 0.0134). Univariate analysis showed that age, duration of AE-IIP till PMX-DHP and P/F ratio were significant predictors of survival. Using multivariate analysis age (p=0.006,HR=19.65) and the duration (p=0.004,HR=22.72) were found to be independent prognostic factors.

Conclusion: This case-control study suggests that PMX-DHP therapy improves survival in AE-IIP patients. The prognostic potential of age and duration of AE-IIP may be useful for the selection of patients who benefit from PMX-DHP.

  • Interstitial lung disease
  • Idiopathic pulmonary fibrosis
  • Exacerbation
  • © 2013 ERS
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Prognostic factors analysis of patients with acute exacerbation of idiopathic interstitial pneumonias treated by polymyxin B hemoperfusion
Keiji Oishi, Keisuke Aoe, Yoriyuki Murata, Kenji Sakamoto, Takashi Ohfuji, Wataru Kotoku, Yoshiko Ogata, Tsuneo Matsumoto, Hiroshi Ueoka, Yusuke Mimura
European Respiratory Journal Sep 2013, 42 (Suppl 57) P462;

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Prognostic factors analysis of patients with acute exacerbation of idiopathic interstitial pneumonias treated by polymyxin B hemoperfusion
Keiji Oishi, Keisuke Aoe, Yoriyuki Murata, Kenji Sakamoto, Takashi Ohfuji, Wataru Kotoku, Yoshiko Ogata, Tsuneo Matsumoto, Hiroshi Ueoka, Yusuke Mimura
European Respiratory Journal Sep 2013, 42 (Suppl 57) P462;
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