Abstract
Objective: The use of therapeutic plasma exchange (TPE) in pediatric intensive care units (PICUs) has increased in recent years. In this study, we retrospectively report and discuss therapeutic plasmapheresis management in the intensive care unit of a children’s hospital.
Material and Methods: Demographic, clinical and laboratory data of the patients who were subjected to TPE between 1 January 2016 and 1 June 2018 were obtained from the hospital information system and medical records.
Results: A total of 190 sessions of therapeutic plasma exchange was performed on 43 patients (Male:Female ratio of 1:1.26). The median age of the patients was 99 months (range 6-214 months). The most common indication was sepsis-related multiple organ failure (n:23, 53.5%). All procedures were conducted using the cell-separator centrifugal method. The ratio of complications during manipulations was 5.7%. No life-threatening complication associated with the therapeutic plasma exchange procedure was observed. The outcome of treatment was complete recovery in 38 (88.4%) patients.
Conclusion: Therapeutic plasma exchange can be used as an important treatment method in critically ill patients in pediatric intensive care units. The procedure can be safely performed in children.
Keywords
References
- 1. Cortina G, McRae R, Chiletti R, Butt W. Therapeutic plasma exchange in critically ill children requiring ıntensive care. Pediatr Crit Care Med 2018;19:97-104.
- 2. Schwartz J, Padmanabha A, Aqui N, Balogun RA, Connelly-Smith L, Delaney M, et al. Guidelines on the use of therapeutic apheresis in clinical practice - evidence-based approach from the writing committee of the american society for apheresis: The seventh special ıssue. J Clin Apher 2016;31:149–62.
- 3. Tekgunduz SA, Kara A, Bozkaya IO, Caglı A, Ozbek NY. Therapeutic plasma exchange in non-hematooncological disorders in pediatrics: A single center experience. Transfus Apher Sci 2018;58:20-2.
- 4. Tolunay İ, Yıldızdaş D, İncecik F, Horoz ÖÖ, Ekinci F, Petmezci E, et al. Çocuk Yoğun Bakım Ünitemizde Terapötik Plazmaferez Uygulanan Nörolojik Hastalarımızın Değerlendirilmesi: 10 yıllık Deneyim. Çocuk acil Yoğun Bakım Dergisi 2015;2:111-14.
- 5. Keskin H, Paksu S, Yener N, Köksoy ÖT, Kartal İ, Albayrak C, et al. Kritik hastalığı olan çocuklarda plazma değişimi: Tek merkez deneyimi. J Pediatr Emerg Intensive care Med 2018;5:10-4.
- 6. Stegmayr BG, Banga R, Berggren L,Norda R, Rydvall A, Vikerfors T. Plasma exchange as rescue therapy in multiple organ failure including acute renal failure. Crit Care Med 2003; 31:1730-36.
- 7. Sevketoglu E, Yildizdas D, Horoz OO, Kihtir HS, Kendirli T, Bayraktar S, et al. Use of therapeutic plasma exchange in children with thrombocytopenia-associated multiple organ failure in the Turkish thrombocytopenia-associated multiple organ failure network. Pediatr Crit Care Med 2014;15:354-9.
- 8. Kıhtır HS, Yeşilbaş O, Kıhtır Z, Yıldırım HM, Şevketoğlu E. Pediatrik olanzapin zehirlenmeleri ve bir olguda plazma değişimi uygulaması: Dört olgu sunumu. Yoğun Bakım Derg 2016;7:34-8.
- 9. Nakanishi T, Suzuki N, Kuragano T, Nagasawa Y, Hasiuke Y. Current topics in therapeutic plasmapheresis. Clin Exp Nephrol 2014;18:41-9.
- 10. Kara A, Turgut S, Cagli A, Sahin F, Oran E, Tunc B. Complications of therapeutic apheresis in children. Transfus Apher Sci 2013;48:375- 76.
- 11. Szczeklik W, Wawrzycka K, Włudarczyk A, Sega A, Nowak I, Seczyńska B, et al. Complications in patients treated with plasmapheresis in the intensive care unit. Anaesthesiol Intensive Ther 2013;45:7-13.
- 12. Sharma RR, Saluja K, Jain A, Dhawan HK, Thakral B, Marwaha N. Scope and application of therapeutic apheresis: Experience from a tertiary care hospital in North India. Transfus Apher Sci 2011;45:239-45.
- 13. Yucesan C, Arslan O, Arat M, Yucemen N, Ayyildiz E, Ilhan O, et al. Therapeutic plasma exchange in the treatment of neuroimmunologic disorders: Review of 50 cases. Transfus Apher Sci 2007;36:103-7.
Abstract
Amaç: Pediatrik yoğun bakım ünitelerinde terapötik plazma değişimi (TPD) uygulamaları son yıllarda artmıştır. Çalışmada, bir çocuk hastanesi yoğun bakım ünitesinde terapötik plazma değişimi uygulamalarımızı geriye dönük olarak araştırmayı ve literatür bilgisi ile tartışmayı amaçladık.
Gereç ve Yöntemler: 1 Ocak 2016 - 1 Haziran 2018 tarihleri arası terapötik plazma değişimi uygulanan hastalara ait demografik, klinik ve laboratuvar verileri hasta dosyaları ve hastane otomasyon sistemi kayıtlarından elde edildi.
Bulgular: 43 hastaya toplam 190 seans terapötik plazma değişimi uygulandı. Erkek:Kız oranı 1:1.26, ortanca yaş 99 ay (6-214 ay )’dı. En sık endikasyon sepsis ilişkili çoklu organ yetmezliği (23 hasta, %53.5) olarak bulundu. Tüm işlemler hücre ayırıcı santrifüj yöntemi kullanılarak yapıldı. İşlemler sırasında %5.7 işlemde komplikasyon görüldü. Hiçbir hastada plazmaferez işlemi ile ilişkili yaşamı tehdit edici bir komplikasyon gelişmedi. Terapötik plazma değişimiyle 38 (%88.4) hastada tam iyileşme görüldü.
Sonuç: Çocuk yoğun bakımda yatan kritik hastaların tedavisinde terapötik plazma değişimi kullanımı önemli bir destek tedavidir ve klinik iyileşmede önemli rol oynar. Ayrıca çocuk hastalarda güvenle uygulanabilmektedir.
Keywords
References
- 1. Cortina G, McRae R, Chiletti R, Butt W. Therapeutic plasma exchange in critically ill children requiring ıntensive care. Pediatr Crit Care Med 2018;19:97-104.
- 2. Schwartz J, Padmanabha A, Aqui N, Balogun RA, Connelly-Smith L, Delaney M, et al. Guidelines on the use of therapeutic apheresis in clinical practice - evidence-based approach from the writing committee of the american society for apheresis: The seventh special ıssue. J Clin Apher 2016;31:149–62.
- 3. Tekgunduz SA, Kara A, Bozkaya IO, Caglı A, Ozbek NY. Therapeutic plasma exchange in non-hematooncological disorders in pediatrics: A single center experience. Transfus Apher Sci 2018;58:20-2.
- 4. Tolunay İ, Yıldızdaş D, İncecik F, Horoz ÖÖ, Ekinci F, Petmezci E, et al. Çocuk Yoğun Bakım Ünitemizde Terapötik Plazmaferez Uygulanan Nörolojik Hastalarımızın Değerlendirilmesi: 10 yıllık Deneyim. Çocuk acil Yoğun Bakım Dergisi 2015;2:111-14.
- 5. Keskin H, Paksu S, Yener N, Köksoy ÖT, Kartal İ, Albayrak C, et al. Kritik hastalığı olan çocuklarda plazma değişimi: Tek merkez deneyimi. J Pediatr Emerg Intensive care Med 2018;5:10-4.
- 6. Stegmayr BG, Banga R, Berggren L,Norda R, Rydvall A, Vikerfors T. Plasma exchange as rescue therapy in multiple organ failure including acute renal failure. Crit Care Med 2003; 31:1730-36.
- 7. Sevketoglu E, Yildizdas D, Horoz OO, Kihtir HS, Kendirli T, Bayraktar S, et al. Use of therapeutic plasma exchange in children with thrombocytopenia-associated multiple organ failure in the Turkish thrombocytopenia-associated multiple organ failure network. Pediatr Crit Care Med 2014;15:354-9.
- 8. Kıhtır HS, Yeşilbaş O, Kıhtır Z, Yıldırım HM, Şevketoğlu E. Pediatrik olanzapin zehirlenmeleri ve bir olguda plazma değişimi uygulaması: Dört olgu sunumu. Yoğun Bakım Derg 2016;7:34-8.
- 9. Nakanishi T, Suzuki N, Kuragano T, Nagasawa Y, Hasiuke Y. Current topics in therapeutic plasmapheresis. Clin Exp Nephrol 2014;18:41-9.
- 10. Kara A, Turgut S, Cagli A, Sahin F, Oran E, Tunc B. Complications of therapeutic apheresis in children. Transfus Apher Sci 2013;48:375- 76.
- 11. Szczeklik W, Wawrzycka K, Włudarczyk A, Sega A, Nowak I, Seczyńska B, et al. Complications in patients treated with plasmapheresis in the intensive care unit. Anaesthesiol Intensive Ther 2013;45:7-13.
- 12. Sharma RR, Saluja K, Jain A, Dhawan HK, Thakral B, Marwaha N. Scope and application of therapeutic apheresis: Experience from a tertiary care hospital in North India. Transfus Apher Sci 2011;45:239-45.
- 13. Yucesan C, Arslan O, Arat M, Yucemen N, Ayyildiz E, Ilhan O, et al. Therapeutic plasma exchange in the treatment of neuroimmunologic disorders: Review of 50 cases. Transfus Apher Sci 2007;36:103-7.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Internal Diseases |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | December 23, 2019 |
| Submission Date | July 14, 2018 |
| Published in Issue | Year 2019 Volume: 13 Issue: 6 |
The publication language of Turkish Journal of Pediatric Disease is English.
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