1Division of Pulmonology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
2Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
3Division of Nephrology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
4Division of Oncology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
5Department of Anesthesiology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
6Department of Thoracic and Cardiovascular Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
Copyright © 2021 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conceptualization: JHL, HJJ. Data curation: JHL, JHP, JHJ, SHK, WH. Formal analysis & Methodology: JHL, JHP, HJK, HKK, YKK, IHK. Visualization: JHL, JHP, BSP, SHP. Writing–original draft: JHL, JHP. Writing–review & editing: all authors.
Characteristics | Value |
---|---|
Age (yr) | 66 (62–74) |
Male sex | 7 (63.6) |
BMI (kg/m2) | 24.1 (20.0–24.8) |
Lung cancer | 3 (27.3) |
Hypertension | 2 (18.2) |
Diabetes mellitus | 1 (9.1) |
Period from ILD diagnosis to AE (mo) | 13 (3–32) |
GAP stage (I:II:III) | 2:6:3 |
SOFA score | 5 (4–6) |
Pulmonary function | |
FVC, % predicted | 51 (47–66) |
FVC, L measured | 2.1 (1.6–2.5) |
DLCO, % predicted | 37 (35–46) |
DLCO, L measured | 7.2 (5.7–8.3) |
6-Minute walk test | 11 (100.0) |
Distance (m) | 345 (209–390) |
Initial SpO2 (%) | 97 (90–98) |
Lowest SpO2 (%) | 87 (76–93) |
Initial P/F ratio | 86 (64–107) |
PaO2 (mm Hg) | 64 (52–71) |
PaCO2 (mm Hg) | 34 (33–40) |
Serum WBC (×106/L) | 16,260 (14,400–22,210) |
Serum CRP (mg/dl) | 14.9 (3.7–20.7) |
Serum LDH (U/L) | 466 (428–582) |
Serum lactate (mmol/L) | 2.0 (1.5–3.0) |
Shocka | 6 (54.5) |
Mechanical ventilation | 7 (63.6) |
Steroid pulse therapy | 10 (90.9) |
500 mg methylPD per day | 5 (45.5) |
1 g methylPD per day | 5 (45.5) |
Immunosuppressant | 4 (36.4) |
Cyclosporin | 4 (36.4) |
Cyclophosphamide | 2 (18.2) |
ECMO | 4 (36.4) |
30-Day mortality | 3 (27.3) |
90-Day mortality | 8 (72.7) |
Values are presented as median (interquartile range) or number (%).
PMX-DHP: polymyxin B-immobilized fiber column; BMI: body mass index; ILD: interstitial lung disease; AE: acute exacerbation; GAP stage: genderage-physiology stage; SOFA: Sequential Organ Failure Assessment; FVC: forced vital capacity; DLCO: diffusing capacity of the lung for carbon monoxide; SpO2: saturation of peripheral oxygen; P/F ratio: the ratio of partial pressure arterial oxygen to fraction of inspired oxygen; WBC: white blood cell; CRP: C-reactive protein; LDH: lactate dehydrogenase; methyl-PD: methylprednisolone; ECMO: extracorporeal membrane oxygenation.
a Shock: use of inotropic agent or vasopressor to maintain adequate tissue perfusion (mean arterial pressure greater than 65 mm Hg).
Variable | Before 1st session | 48 Hours later | Crude P-value | Adjusted P-valuea |
---|---|---|---|---|
P/F ratio | 86 (63–106) | 145 (86–260) | 0.030 | 0.035 |
IL-6 (pg/ml) | 79 (35–640) | 10 (5–25) | 0.018 | 0.408 |
WBC (×106/L) | 16,260 (14,400–22,210) | 14,070 (9,132–23,917) | 0.386 | 0.608 |
CRP (mg/dl) | 14 (4–21) | 5 (2–6) | 0.019 | 0.024 |
Values are presented as median (interquartile range).
P/F ratio: the ratio of partial pressure arterial oxygen to fraction of inspired oxygen; IL: interleukin; WBC: white blood cell; CRP: C-reactive protein; PMX-DHP: polymyxin B-immobilized fiber column.
a P-values were adjusted for application of mechanical ventilation, use of steroid pulse therapy, steroid dose, and use of immunosuppressant.