A pilot study: a combined therapy using polymyxin-B hemoperfusion and extracorporeal membrane oxygenation for acute exacerbation of interstitial pneumonia.

Abstract

BACKGROUND:

Direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) might be beneficial for treating acute exacerbation (AE) of interstitial pneumonia (IP). Venovenous extracorporeal membranous oxygenation (VV-ECMO) is an emerging tool to avoid ventilator-induced lung injury. This is a report presenting the first three patients with AE of IP treated with a combined therapy of PMX-DHP and VV-ECMO.

CASE PRESENTATION:

Patient 1 was a 68-year-old male with acute interstitial pneumonia, patient 2 a 67-year-old male with AE of idiopathic pulmonary fibrosis, and patient 3 a 61-year-old female with AE of collagen vascular disease-associated interstitial pneumonia. All patients were severely hypoxemic and required mechanical ventilation. A combined therapy using PMX-DHP and VV-ECMO was initiated with support of intravenous corticosteroids and antibiotics. Radiological findings, oxygenation and laboratory findings markedly improved and all patients survived without severe complications.

CONCLUSION:

A combined therapy of PMX-DHP and VV-ECMO might be a therapeutic option for AE of IP.

• Authors: Junji Itai, Shinichiro Ohshimo, Yoshiko Kida, Kohei Ota, Yasumasa Iwasaki, Nobuyuki Hirohashi, Francesco Bonella, Josune Guzman, Ulrich Costabel, Nobuoki Kohno, Koichi Tanigawa
• Journal: Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG (Sarcoidosis Vasc Diffuse Lung Dis) Vol. 31 Issue 4 Pg. 343-9 (Jan 05 2015) ISSN: 2532-179X [Electronic] Italy
• PMID: 25591146 (Publication Type: Case Reports, Journal Article)

Chemical References

• Polymyxin B

Topics

• Aged
• Combined Modality Therapy
• Disease Progression
• Extracorporeal Membrane Oxygenation
• Female
• Hemoperfusion (methods)
• Humans
• Idiopathic Pulmonary Fibrosis (diagnosis, therapy)
• Lung Diseases, Interstitial (diagnosis, therapy)
• Male
• Middle Aged
• Polymyxin B (therapeutic use)
• Tomography, X-Ray Computed
• Treatment Outcome