Outcomes of previously healthy pediatric patients with fulminant sepsis‐induced multisystem organ failure receiving therapeutic plasma exchange

Qu, Lirong; Kiss, Joseph E.; Dargo, Gina; Carcillo, Joseph A.

doi:10.1002/jca.20296

Cited by 47 publications

(45 citation statements)

References 31 publications

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“…1). Similar outcomes were obtained in a study of 11 paediatric patients [7]. Improvements in the coagulation profile and organ function were achieved in our patients after 4 to 5 separations, which is consistent with the principle of PE.…”

Section: Discussionsupporting

confidence: 90%

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Efficacy of plasma exchange in septic shock: a case report

Sołtysiak

Bartkowska-Śniatkowska²,

Rosada-Kurasińska³

et al. 2014

Anaesthesiol Intensive Ther

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The mortality rate for severe sepsis and septic shock remains high. Additionally, this life-threatening state poses serious difficulties for the treatment of patients. Unfortunately, the mechanism of sepsis is complex and not well understood. In this paper, we present the case of a 2.5-year-old female with septic shock treated with plasma exchange (PE) as a nonstandard therapy. We analysed the medical history of disease, including patient data, physical examination, laboratory tests and treatment. Unexpectedly, we achieved clinical improvement after the first PE. During PE, the dose of catecholamine was reduced. In addition, the level of C-reactive protein seemed to be a better predictor of the efficacy of PE in septic shock compared to procalcitonin. We conclude that PE may improve the survival rate for patients with septic shock. These data could be useful in the search and introduction of new or alternative methods of treatment for critically ill children.

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Section: Discussionsupporting

confidence: 90%

“…However, current guidelines for PE do not cover severe sepsis and septic shock [6]. There are several reports to suggest that PE may be a relevant adjuvant to conventional treatment and may reduce mortality in individuals with severe sepsis and septic shock [1, 4,7,8].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of plasma exchange in septic shock: a case report

Sołtysiak

Bartkowska-Śniatkowska²,

Rosada-Kurasińska³

et al. 2014

Anaesthesiol Intensive Ther

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“…En una reciente comunicación, Qu et al 44 analizaron una casuística de once pacientes que recibieron plasmaféresis diariamente. En la mayoría de los pacientes, se observó una mejoría en la disfunción orgánica al cabo de 2-4 sesiones, y se destacó que los sobrevivientes tuvieron un inicio precoz de la plasmaféresis (5,3 horas).…”

Section: Plasmaféresisunclassified

Shock séptico en la Unidad de Cuidados Intensivos. Terapéutica avanzada, inmunoparálisis y genómica. Estado del arte

R³

et al. 2014

Arch Argent Pediat

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New and important concepts have emerged for the advanced management of the child with septic shock in the recent decades. Attending physicians in the Pediatric intensive care unit must be fully aware of them to improve patient care in the critical care unit. It should be considered the use of immune therapy only in selected groups of patients. Continuous renal replacement therapies are well tolerated and their early use prevents deleterious fluid overload. Removal of inflammatory mediators by using high volume hemofiltration may play a role in hyperdynamic septic patients. The use of plasmapheresis is recommended in patients with thrombocytopenia-associated multiple organ failure. Extracorporeal support use should be considered in those with refractory septic shock despite goals directed therapy. The immunoparalysis has been associated with nosocomial infections and late mortality. The information from genetic markers may allow early intervention and preventive genomicsbased medicine.

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“…There is no evidence suggesting that particular forms of renal support therapy (e.g., peritoneal dialysis, hemodialysis or continuous hemofiltration) are of particular benefit in septic shock, although technical considerations may give rise to preferences for the mode of support used. There is some limited evidence that plasmapheresis may improve outcomes from severe sepsis [101], while a recent study reported that in a group of 12 previously well patients with multi-system organ failure related to septic shock (8 with meningococcemia), early initiation of therapeutic plasma exchange was associated with good quality survival in 11 [101].…”

Section: Renal Support Therapymentioning

confidence: 99%

What’s New in the Recognition and Management of Septic Shock in Children: Dos and Don'ts

Argent

2013

Curr Pediatr Rep

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While there has been a reduction in the number of children dying of septic shock in the richer countries of the world, septic shock remains an important cause of both mortality and morbidity for children across the world. Major reduction in the incidence of septic shock will depend on the implementation of public health measures, including immunization. Improvements in outcome of pediatric septic shock have been closely linked to early recognition (although this may be challenging in many situations); early antibiotic administration; early and appropriate fluid administration and subsequent escalation of critical care. A particular challenge has been the development and implementation of systems to ensure that these elements of management are reliably and efficiently implemented in children (even in well-resourced countries). Recent studies have highlighted the complexity of caring for patients with acute severe sepsis and septic shock in countries with fewer resources, and there is an urgent need for further studies to elucidate the implications of these studies for the management of children with septic shock, particularly in settings where additional critical care support such as inotropic or ventilator support may not be readily available.

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Outcomes of previously healthy pediatric patients with fulminant sepsis‐induced multisystem organ failure receiving therapeutic plasma exchange

Abstract: > TPE may contribute to a better outcome in previously healthy pediatric patients with fulminant sepsis-induced MSOF, especially if instituted early in the course of multiorgan failure.

Cited by 47 publications

References 31 publications

Efficacy of plasma exchange in septic shock: a case report

Efficacy of plasma exchange in septic shock: a case report

Shock séptico en la Unidad de Cuidados Intensivos. Terapéutica avanzada, inmunoparálisis y genómica. Estado del arte

What’s New in the Recognition and Management of Septic Shock in Children: Dos and Don'ts

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