Assessment of neurologic patients who treated therapeutic plasmapheresis at pediatric intensive care unit: 10 years experience

Tolunay, İlknur; Yildizdaş, Riza; İncecik, Faruk; Horoz, Özden Özgür; Ekinci, Faruk; Petmezci, Ercüment; Hergüner, M. Özlem

doi:10.5505/cayb.2015.32042

Cited by 4 publications

(7 citation statements)

References 15 publications

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“…Treatment should be initiated as soon as the patient is diagnosed. Plasmapheresis treatment improves motor nerve healing and decreases mechanical ventilator support duration …”

Section: Discussionmentioning

confidence: 99%

“…Plasmapheresis treatment improves motor nerve healing and decreases mechanical ventilator support duration. 36 ADEM is a neurologic disease affecting the white matter of brain and spinal cord and is caused by disseminated multifocal inflammation and demyelination secondary to autoimmune response. According to ASFA, TPE should be considered as a second line treatment in patients unresponsive to high-dose intravenous corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic plasma exchange in pediatric intensive care: Indications, results and complications

et al. 2020

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Therapeutic plasma exchange (TPE) is an effective treatment method in selective indications. Secondary to access and technical features, it is more difficult to apply in pediatric population than adults. The aim of this study is investigate safety, clinical indications, and results of this method in critically ill pediatric patients who need TPE treatment. All of the TPE procedures performed in a pediatric intensive care unit providing tertiary care during 4 years (2015–2019) were evaluated retrospectively. TPE procedures (635) were performed for 135 patients. Median age was 34 months (10‐108). Ninety‐seven patients had mechanical ventilation support. Sepsis with multiple organ failure was the most frequent indication and accounted for 44.4% (n = 60) of the indications followed by hematological and neurological diseases (19.2% and 9.6% respectively). TPE was performed alone in 469 cases (73.9%), in combination with continuous renal replacement therapy in 154 cases (24.2%), and additional to extracorporeal membrane oxygenation in 12 cases (1.9%). Hematological disease and sepsis subgroups had the highest intubation rate, mechanical ventilation period, PRISM score, organ failure count, and mortality. Fresh frozen plasma (FFP) was the most frequently used replacement fluid in 90.4% of the procedures. The most frequent anticoagulant used in TPE was acid citrate dextrose solution (79.3%). Procedural complications were detected in 104 cases (16.3%) and occurred during TPE sessions. Overall survival rate was 78.5%. We found that the non‐survivor group had significantly higher rates of organ failures (P = 0.0001), higher PRISM scores on admission (P = 0.0001), and higher rates of invasive ventilation support needed (P = 0.012). TPE is a treatment method which can be safely provided in healthcare facilities with necessary medical and technical requirements. Although it is riskier to provide such treatment to critically ill children, complications can be minimized in experienced healthcare facilities. Overall results are good and can vary depending on indication.

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“…Treatment should be initiated as soon as the patient is diagnosed. Plasmapheresis treatment improves motor nerve healing and decreases mechanical ventilator support duration …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Therapeutic plasma exchange in pediatric intensive care: Indications, results and complications

et al. 2020

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“…According to the ASFA criteria, TPE is the first-line treatment (category I) in patients with neurological diseases such as GBS and anti-N-methyl-D-aspartate (NMDA) receptor encephalitis. 2,23 In a multicenter retrospective study with 49 153 patients, 25.6% of patients are diagnosed with neurological diseases and it is reported that the survival rate in patients treated with TPE was significantly higher, compared to the neurological patients not treated with TPE. 17 In our study, 9.8% of our patients were diagnosed with neurological diseases.…”

Section: Discussionmentioning

confidence: 99%

Retrospective evaluation of therapeutic plasma exchange treatment in a pediatric intensive care unit: Single‐center experience

Durak¹,

Sahin²,

Can³

et al. 2023

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BackgroundThe aim of this study is to characterize the clinical indications, outcomes, and complications of therapeutic plasma exchange (TPE) in pediatric intensive care unit.MethodsA retrospective study was conducted on critically ill patients who received TPE. A dataset of 672 treatments administered to 102 patients was analyzed.ResultsThe most common indication for TPE was COVID‐19‐related clinical conditions, followed by sepsis (24.5%), neurological diseases (9.8%) and renal diseases (6.9%). None of our patients died due to TPE‐related complications, and the most common complication during and after the TPE was hypotension (21.7%).ConclusionAlthough TPE is riskier to provide to critically ill children, our experience indicates that it can be performed relatively safely in critically ill children with appropriate treatment indications. In particular, indications, onset time, number of sessions and other procedures should be standardized for the pediatric age group.

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“…A girl with the diagnosis of systemic lupus erythematosus that underwent TPE for hemolytic anemia developed allergic reaction and thus was administered 5% albumin as a replacement fluid in the subsequent sessions. Tolunay et al [12], in a study whereby they assessed patients with neurological disorders undergoing plasmapheresis, reported that they most commonly encountered hypotension at a rate of 29.2%, followed by fever and allergic reactions with a rate of 9.7% and hypertension with a rate of 4.8%. We are of the opinion that making a correct indication, selection of a correct replacement fluid, and the team having experience in the procedure is equally effective in procedural success.…”

Section: Discussionmentioning

confidence: 99%

Assessment of patients undergoing therapeutic plasmapheresis

Erdoğan¹

2019

Ann Clin Anal Med

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Aim: Therapeutic plasma exchange (TPE) is an extracorporeal treatment technique that allows the removal of unwanted substances with large molecule weight from the blood. In this study, it was aimed to retrospectively assess patients who underwent therapeutic plasmapheresis. Material and Method: The medical data of patients who underwent TPE in the 10-bed pediatric intensive care unit of Ümraniye TRH between May 2017 and May 2018 were retrospectively assessed. Age, sex, body weight, plasmapheresis indications, plasmapheresis technique, complication and mortality rates were recorded. Results: TPE was performed in a total of 19 patients. The mean age of the study population was 8.8 ± 5.9 years. Ten (52.6%) patients were provided respiratory support with mechanical ventilator; the mean duration of ventilator support for these patients was 10.3 ± 10 days. The most common indication for TPE was autoimmune encephalitis with a rate of 42% (8/19 patients); the other indications were: collagen tissue disorder activation, hepatic failure, mitochondriopathic encephalopathy, Guillain-Barre syndrome, septic shock, and hemophagocytic syndrome. The patients were administered totally 5.94 ± 1.69 sessions of TPE, min 3-max 8). As a replacement fluid, fresh frozen plasma (FFP) was used in 17 patients and albumin in 2 patients. The most common complication was catheter-related complications. None of the patients died during the procedure. One patient was followed up for Hashimoto encephalitis and another patient who was followed up for septic shock died. Discussion: TPE is a treatment method that is invasive but with low-side effect profile; it is used to stop disease progression in lifethreatening autoimmune disorders unresponsive to a medical treatment.

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Assessment of neurologic patients who treated therapeutic plasmapheresis at pediatric intensive care unit: 10 years experience

Abstract: Methods:Results: --2015;2(3):111-4.

Cited by 4 publications

References 15 publications

Therapeutic plasma exchange in pediatric intensive care: Indications, results and complications

Therapeutic plasma exchange in pediatric intensive care: Indications, results and complications

Retrospective evaluation of therapeutic plasma exchange treatment in a pediatric intensive care unit: Single‐center experience

Assessment of patients undergoing therapeutic plasmapheresis

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