Evaluation of different perfusion durations in direct hemoperfusion with polymyxin B-immobilized fiber column therapy for acute exacerbation of interstitial pneumonias

Blood Purif. 2011;32(2):75-81. doi: 10.1159/000320128. Epub 2011 Mar 2.

Abstract

Background: Recently, the potential therapeutic effect of direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) has been reported for acute exacerbation of interstitial pneumonia (AE-IP), a highly morbid clinical event; however, there is no consensus on the appropriate procedure for PMX-DHP. We examined the appropriate perfusion duration of PMX-DHP for AE-IP.

Methods: AE-IP patients receiving PMX-DHP were divided into two groups: short-duration group (≤6 h) (n = 5) and long-duration group (12 h) (n = 12).

Results: ThePaO(2)/FiO(2) (P/F) ratio increased immediately after PMX-DHP in the two groups. In the long-duration group, the P/F ratio continued to increase over the following 7 days, while, in the short-duration group, the P/F ratio declined again 3 days after therapy. The survival rate 30 days after PMX-DHP was significantly higher in the long-duration group than in the short-duration group.

Conclusions: A long perfusion duration of PMX-DHP is more efficacious for AE-IP than a short perfusion duration.

MeSH terms

  • Acute Disease
  • Adrenal Cortex Hormones / administration & dosage
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / metabolism*
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / administration & dosage
  • Dicarbethoxydihydrocollidine / analogs & derivatives*
  • Dicarbethoxydihydrocollidine / chemistry
  • Dicarbethoxydihydrocollidine / metabolism
  • Female
  • Hemoperfusion / methods*
  • Humans
  • Immobilized Proteins / chemistry
  • Immobilized Proteins / metabolism*
  • Lung Diseases, Interstitial / mortality
  • Lung Diseases, Interstitial / physiopathology
  • Lung Diseases, Interstitial / therapy*
  • Male
  • Polymyxin B / chemistry
  • Polymyxin B / metabolism*
  • Polymyxin B / therapeutic use
  • Respiratory Function Tests
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome

Substances

  • 2,6-dimethyl-3,5-diethoxycarbonyl-4-carboxyl-1,4-dihydropyridine
  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Immobilized Proteins
  • Dicarbethoxydihydrocollidine
  • Polymyxin B