Abstract
We retrospectively investigated the differences in clinical course for 8 patients who developed acute exacerbation of interstitial pneumonia and who were treated in the ICU from December 2005 to May 2008. All patients received high-dose corticosteroid therapy, and four also underwent polymyxin B-immobilized fiber column hemoperfusion (PMX-DHP) treatment, which was initiated as soon as possible after ICU admission and carried out at a flow rate of 80–100 ml·min−1 for 4–6 hours every 2 days. The mean P/F ratio in the 4 patients without PMX-DHP (N group) was 78.8±25.6 (mean±SD) at ICU admission and was 115.7±90.8 at 48 hours post ICU admission. In the patients undergoing PMX-DHP (P group), P/F ratio improved markedly from 87.5±22.7 to 168±64.9 during the identical period. The 1-month and 3-month survival rates in N group were 50 and 25%, while those in P group were 100 and 75%, respectively. All patients in N group were intubated and ventilated mechanically, while only 1 patient in P group required non-invasive positive pressure ventilation for 10 hours. The differences of clinical course between N and P groups suggest that PMX-DHP is effective for acute exacerbation of interstitial pneumonia.
