CLINICAL EFFICACY OF SUSTAINED HIGH-EFFICACY DAILY DIAFILTRATION USING A MEDIATOR-ADSORBING MEMBRANE AND DIRECT HEMOPERFUSION WITH A POLYMYXIN B-IMMOBILIZED FIBER COLUMN IN TREATING ACUTE EXACERBATION OF IDIOPATHIC INTERSTITIAL PNEUMONIAS

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  • Komaki Chihito
    Department of Respiratory Medicine, Matsunami General Hospital
  • Niwa Takashi
    Department of Respiratory Medicine, Matsunami General Hospital
  • Inoue Yousuke
    Department of Respiratory Medicine, Matsunami General Hospital

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Other Title
  • 特発性間質性肺炎の急性増悪に対するエンドトキシン吸着療法と血液濾過透析の併用治療の効果の検討
  • トクハツセイ カンシツセイ ハイエン ノ キュウセイ ゾウアク ニ タイスル エンドトキシン キュウチャク リョウホウ ト ケツエキ ロカ トウセキ ノ ヘイヨウ チリョウ ノ コウカ ノ ケントウ

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Abstract

Objectives: The aim of this study is to investigate the clinical outcomes of patients with steroidresistant acute exacerbation of idiopathic interstitial pneumonias treated with blood purification therapy comprising direct hemoperfusion using a polymyxin B-immobilized fiber column (PMX-DHP) and sustained high-efficacy daily diafiltration using a mediator-adsorbing membrane (SHEDD-fA). Methods: The clinical outcomes and respiratory function were retrospectively compared between 6 patients who underwent blood purification therapy (blood purification group) and 15 patients (control group) who blood purification therapy. Results: The patients in the blood purification group showed a higher PaO2/FiO2 ratio than those in the control group. Twenty-eight days (83%; 5/6 vs. 20%; 3/15) and ninety days (67%; 4/6 vs. 6.7%; 1/15) survival rates were also higher in the blood purification group. The blood purification group also showed a better 90-day survival curve (Hazard ratio=0.260) compared to the control group. Conclusions : In conclusion, combination blood purification therapy comprising PMX-DHP and SHEDD-fA may be used to treat acute exacerbation of idiopathic interstitial pneumonias.

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