Changes in Oxygenation and Serological Markers in Acute Exacerbation of Interstitial Lung Disease Treated with Polymyxin B Hemoperfusion

Abstract

Background: Polymyxin B direct hemoperfusion (PMX‐DHP) has been tried in acute exacerbation of interstitial lung disease (AE‐ILD) patients and has shown clinical benefit. In this study, we tried to investigate the change in oxygenation and serologic markers after PMX‐DHP treatment in AE‐ILD patients in Korea. Methods: We reviewed the medical records of twenty‐two patients who were admitted for AE‐ILD and underwent PMX‐DHP treatment. Changes in vital signs and laboratory findings before and after treatment were compared and factors related to 90‐ day mortality were analyzed using the Cox regression model. Results: Of the 22 included patients, 11 (50%) patients were diagnosed with idiopathic pulmonary fibrosis. In AE‐ILD patients treated with PMX‐DHP, the 28‐day mortality rate was 45.5% and the 90‐day mortality rate was 72.7%. The P/F ratio before and after PMX‐DHP treatment significantly improved in patients from baseline to 24 h (median (IQR), 116.3 (88.5–134.3) mmHg vs. 168.6 (115.5–226.8) mmHg, p = 0.001), and 48 h (116.3 (88.5–134.3) mmHg vs. 181.6 (108.9–232.0) mmHg, p = 0.003). Also, white blood cells (WBCs) and C‐reactive protein (CRP) were decreased after PMX‐DHP treatment. High acute physiology and chronic health evaluation II scores were associated with 90‐day mortality. Conclusions: In patients with AE‐ILD, PMX‐DHP treatment was associated with an improved P/F ratio and lower WBC and CRP levels.