Assessment of patients undergoing therapeutic plasmapheresis

Abstract

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.