Efficacy of direct hemoperfusion using polymyxin B-immobilized fiber column in acute respiratory failure patients = Efficacy of direct hemoperfusion using polymyxin B-immobilized fiber column in acute respiratory failure patients

다국어 초록 (Multilingual Abstract)

Introduction: Direct hemoperfusion using polymyxin B-immobilized fiber column(PMX-DHP) therapy has been used for critical ill patients, but its efficacy for acute respiratory failure is unclear. We evaluated efficacy and prognostic factor of the PMX-DHP in patients with acute respiratory failure.
Methods: This study evaluated retrospectively our experience with PMX-DHP between March 2017 and september 2018 in Kyunghee university and Chungnam national university hostpial. PMX-DHP was implemented patients from multiple etiologies with acute respiratory failure. Laboratory parameters include arterial blood gas analysis, ventilator parameters, hemodynamic parameter and adverse events were recorded serially. Our primary outcome was ICU mortality.
Results: Between March 2013 and August 2016, we enrolled 9 patients with severe respiratory failure, Median age was 63.5±8.2 and 6 patients was male. Eight patients had mechanical ventilator, one patient underwent high flow nasal cannula and 2 patients had interventional lung assis. Causes of respiratory failure were pneumonia (3 patients), extrapulmonary ARDS (2 patients), IPF exacerbation (2 patients) and RA-ILD(2patients). ICU mortality was 28.5% and 28d days mortality was 33.3%. 2 IPF exacerbation patients survived in ICU. Surivival patients lead to an acute and moderate increase in arterial oxygenation (PaO2/FiO2 ratio 2hr after initiation of PMX-DHP (150 ±25 mmHg) compared with pre PMX-DHP (110±20.2 mmHg) and rapid shock recovery. Ground glass opacity group showed higher survival group than consolidation group.
Conclusion: PMX-DHP therapy may be effective in respiratory failure and is expected to reduce mortality rates.