Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterized by dyspnea and a worsening of the lung function. Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are defined by a clinically significant respiratory deterioration, that typically deve...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Critical Care Medicine
2020-11-01
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| Series: | Acute and Critical Care |
| Subjects: | |
| Online Access: | http://www.accjournal.org/upload/pdf/acc-2020-00038.pdf |
| _version_ | 1819141398090219520 |
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| author | Shin Young Kim Jin Han Park Hyo Jung Kim Hang Jea Jang Hyun Kuk Kim Seung Hoon Kim Jae Ha Lee |
| author_facet | Shin Young Kim Jin Han Park Hyo Jung Kim Hang Jea Jang Hyun Kuk Kim Seung Hoon Kim Jae Ha Lee |
| author_sort | Shin Young Kim |
| collection | DOAJ |
| description | Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterized by dyspnea and a worsening of the lung function. Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are defined by a clinically significant respiratory deterioration, that typically develops in less than 1 month, accompanied by new radiologic abnormalities on high-resolution computed tomography, including diffused and bilateral ground-glass opacification, along with an absence of other obvious clinical etiologies. Recently, AE-IPF has gained significant importance as a major cause of mortality and morbidity. However, despite the extremely poor prognosis of the condition, no well-validated therapeutic interventions are currently available. Therefore, novel treatment modalities are being investigated and applied in addition to conventional treatments. Among them, several studies have reported that a direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP), developed for endotoxin removal in septic shock, has an effect on AE-IPF. We describe two cases of PMX-DHP treatment with conflicting results. One patient successfully recovered via a PMX-DHP in severe AE-IPF that required extracorporeal membrane oxygenation (ECMO). PMX-DHP subsequently improved oxygenation (PaO2/FiO2 ratio) and decreased the levels of inflammatory markers (interleukin-6, C-reactive protein, and white blood cells). The patient dramatically recovered without the need for ECMO. PMX-DHP may be considered an alternative therapy in AE-IPF patients requiring mechanical ventilation or ECMO. |
| first_indexed | 2024-12-22T11:53:49Z |
| format | Article |
| id | doaj.art-d98147f42f2b479594df291a2ee6dbbf |
| institution | Directory Open Access Journal |
| issn | 2586-6052 2586-6060 |
| language | English |
| last_indexed | 2024-12-22T11:53:49Z |
| publishDate | 2020-11-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Acute and Critical Care |
| spelling | doaj.art-d98147f42f2b479594df291a2ee6dbbf2022-12-21T18:26:55ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602020-11-0135430230610.4266/acc.2020.000381230Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosisShin Young Kim0Jin Han Park1Hyo Jung Kim2Hang Jea Jang3Hyun Kuk Kim4Seung Hoon Kim5Jae Ha Lee6 Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St. Vincent’s Hospital, Suwon, Korea Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St. Vincent’s Hospital, Suwon, Korea Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, KoreaIdiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterized by dyspnea and a worsening of the lung function. Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are defined by a clinically significant respiratory deterioration, that typically develops in less than 1 month, accompanied by new radiologic abnormalities on high-resolution computed tomography, including diffused and bilateral ground-glass opacification, along with an absence of other obvious clinical etiologies. Recently, AE-IPF has gained significant importance as a major cause of mortality and morbidity. However, despite the extremely poor prognosis of the condition, no well-validated therapeutic interventions are currently available. Therefore, novel treatment modalities are being investigated and applied in addition to conventional treatments. Among them, several studies have reported that a direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP), developed for endotoxin removal in septic shock, has an effect on AE-IPF. We describe two cases of PMX-DHP treatment with conflicting results. One patient successfully recovered via a PMX-DHP in severe AE-IPF that required extracorporeal membrane oxygenation (ECMO). PMX-DHP subsequently improved oxygenation (PaO2/FiO2 ratio) and decreased the levels of inflammatory markers (interleukin-6, C-reactive protein, and white blood cells). The patient dramatically recovered without the need for ECMO. PMX-DHP may be considered an alternative therapy in AE-IPF patients requiring mechanical ventilation or ECMO.http://www.accjournal.org/upload/pdf/acc-2020-00038.pdfidiopathic pulmonary fibrosispolymyxin bprognosis |
| spellingShingle | Shin Young Kim Jin Han Park Hyo Jung Kim Hang Jea Jang Hyun Kuk Kim Seung Hoon Kim Jae Ha Lee Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis Acute and Critical Care idiopathic pulmonary fibrosis polymyxin b prognosis |
| title | Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis |
| title_full | Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis |
| title_fullStr | Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis |
| title_full_unstemmed | Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis |
| title_short | Direct hemoperfusion with polymyxin B-immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis |
| title_sort | direct hemoperfusion with polymyxin b immobilized fiber column in a patient with acute exacerbation of idiopathic pulmonary fibrosis |
| topic | idiopathic pulmonary fibrosis polymyxin b prognosis |
| url | http://www.accjournal.org/upload/pdf/acc-2020-00038.pdf |
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