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- Title
Polymyxin B-immobilised fibre column treatment for acute exacerbation of idiopathic pulmonary fibrosis patients with mechanical ventilation: a nationwide observational study.
- Authors
Awano, Nobuyasu; Jo, Taisuke; Izumo, Takehiro; Inomata, Minoru; Ito, Yu; Morita, Kojiro; Matsui, Hiroki; Fushimi, Kiyohide; Urushiyama, Hirokazu; Nagase, Takahide; Yasunaga, Hideo
- Abstract
Background: The prognosis for acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is poor, and there is no established treatment. Hence, we aimed to investigate the effectiveness of a polymyxin B-immobilised fibre column (PMX) for the treatment of AE-IPF. Methods: Data were retrospectively collected from the Japanese Diagnosis Procedure Combination database from 1 July 2010 to 31 March 2018. We identified adult patients with idiopathic pulmonary fibrosis who received high-dose methylprednisolone (mPSL) therapy and mechanical ventilation upon admission. Eligible patients (n = 5616) were divided into those receiving PMX treatment combined with high-dose mPSL (PMX group, n = 199) and high-dose mPSL alone (mPSL alone group, n = 5417). To compare outcomes between the two groups, we applied a stabilised inverse probability of treatment weighting (IPTW) using propensity scores. The primary outcome was in-hospital mortality, and the secondary outcomes were 14- and 28-day mortality and length of hospital stay. Results: The in-hospital mortality rates of the PMX and mPSL alone groups were 79.9% and 76.4%, respectively. The results did not significantly differ between the two groups after performing a stabilised IPTW. The odds ratio of the PMX group compared with the mPSL alone group was 1.56 (95% confidence interval 0.80–3.06; p = 0.19). The 14- and 28-day mortality and length of hospital stay (secondary outcomes) also did not significantly differ between the two groups. Conclusions: In AE-IPF patients using mechanical ventilation, the treatment outcome was not significantly better for PMX combined with high-dose mPSL than for high-dose mPSL alone.
- Subjects
IDIOPATHIC pulmonary fibrosis; DISEASE exacerbation; ARTIFICIAL respiration; POLYMYXIN; LENGTH of stay in hospitals
- Publication
Journal of Intensive Care, 2023, Vol 11, Issue 1, p1
- ISSN
2052-0492
- Publication type
Article
- DOI
10.1186/s40560-023-00693-0