Scope, Safety, and Feasibility of Therapeutic Plasma Exchange in Pediatric Intensive Care Unit: A Single-center Experience.
Acute liver failure
American society for apheresis
Paediatric Intensive care
Plasmapheresis
Therapeutic plasma exchange
Thrombotic microangiopathy
Journal
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
ISSN: 0972-5229
Titre abrégé: Indian J Crit Care Med
Pays: India
ID NLM: 101208863
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
06
06
2023
accepted:
25
08
2023
medline:
1
11
2023
pubmed:
1
11
2023
entrez:
1
11
2023
Statut:
ppublish
Résumé
Indications for therapeutic plasma exchange (TPE) in the pediatric intensive care unit (PICU) are expanding. We aimed to study the demographics, clinical indications, and outcomes of patients who have undergone TPE in our PICU. This is a retrospective study performed among children aged from 1 month to 16 years of age. Demographics, indications, therapeutic response, serious adverse events (SAE), PICU length of stay (LOS), and death during hospitalization were studied as outcome variables. Therapeutic plasma exchange was performed in 115 sessions on 24 patients for 12 different indications falling under various American Society for Apheresis (ASFA) categories. Therapeutic plasma exchange was performed on ten, four, and ten children for ASFA category I, II, and III indications, respectively. The most common indications were thrombotic microangiopathy (TMA) (8/24) and acute liver failure (ALF) (6/24). During those 115 sessions, a total of five serious adverse events (SAEs) occurred, accounting for 4.3% of the cases. Minor adverse events occurred in 12 sessions (10.4%). Therapeutic response was good in 17 patients (71%) including 5 patients who underwent standard volume TPE (SV-TPE) for ALF. Median PICU LOS was 9 (range 2-120) days. The mortality rate was 12.5% (3/24). Therapeutic plasma exchange is effective in various clinical conditions involving various organ systems. It is an excellent therapeutic modality in children with ALF, irrespective of the exchange volume and TMA. However, SAEs do occur in the minority. Balasubramanian KK, Venkatachalapathy P, Margabandhu S, Natraj R, Sridaran VK, Lakshmanan C,
Sections du résumé
Background
UNASSIGNED
Indications for therapeutic plasma exchange (TPE) in the pediatric intensive care unit (PICU) are expanding. We aimed to study the demographics, clinical indications, and outcomes of patients who have undergone TPE in our PICU.
Materials and methods
UNASSIGNED
This is a retrospective study performed among children aged from 1 month to 16 years of age. Demographics, indications, therapeutic response, serious adverse events (SAE), PICU length of stay (LOS), and death during hospitalization were studied as outcome variables.
Results
UNASSIGNED
Therapeutic plasma exchange was performed in 115 sessions on 24 patients for 12 different indications falling under various American Society for Apheresis (ASFA) categories. Therapeutic plasma exchange was performed on ten, four, and ten children for ASFA category I, II, and III indications, respectively. The most common indications were thrombotic microangiopathy (TMA) (8/24) and acute liver failure (ALF) (6/24). During those 115 sessions, a total of five serious adverse events (SAEs) occurred, accounting for 4.3% of the cases. Minor adverse events occurred in 12 sessions (10.4%). Therapeutic response was good in 17 patients (71%) including 5 patients who underwent standard volume TPE (SV-TPE) for ALF. Median PICU LOS was 9 (range 2-120) days. The mortality rate was 12.5% (3/24).
Conclusion
UNASSIGNED
Therapeutic plasma exchange is effective in various clinical conditions involving various organ systems. It is an excellent therapeutic modality in children with ALF, irrespective of the exchange volume and TMA. However, SAEs do occur in the minority.
How to cite this article
UNASSIGNED
Balasubramanian KK, Venkatachalapathy P, Margabandhu S, Natraj R, Sridaran VK, Lakshmanan C,
Identifiants
pubmed: 37908426
doi: 10.5005/jp-journals-10071-24541
pmc: PMC10613876
doi:
Types de publication
Journal Article
Langues
eng
Pagination
766-770Informations de copyright
Copyright © 2023; The Author(s).
Déclaration de conflit d'intérêts
Source of support: Nil Conflict of interest: None
Références
Indian Pediatr. 2021 Dec 15;58(12):1151-1154
pubmed: 34183464
Transfus Apher Sci. 2003 Oct;29(2):159-66
pubmed: 12941356
Ther Apher Dial. 2020 Apr;24(2):221-229
pubmed: 31922326
Transfus Apher Sci. 2020 Oct;59(5):102959
pubmed: 33011077
J Clin Apher. 2017 Dec;32(6):494-500
pubmed: 28485072
Pediatr Nephrol. 2022 Aug;37(8):1775-1788
pubmed: 34647173
Transfus Apher Sci. 2007 Feb;36(1):13-6
pubmed: 17234456
J Clin Apher. 2019 Jun;34(3):171-354
pubmed: 31180581
Asian J Transfus Sci. 2018 Jul-Dec;12(2):127-135
pubmed: 30692797
Transfus Apher Sci. 2008 Dec;39(3):255-60
pubmed: 19010084
Med Arch. 2016 Oct;70(5):332-335
pubmed: 27994290
Ther Apher Dial. 2014 Oct;18(5):497-501
pubmed: 24674133
Clin Kidney J. 2015 Dec;8(6):702-7
pubmed: 26613028
Indian J Pediatr. 2021 Aug;88(8):757-763
pubmed: 33527338
J Clin Apher. 2012;27(6):287-94
pubmed: 22811262
J Clin Apher. 2016 Aug;31(4):381-7
pubmed: 26212115
Pediatr Crit Care Med. 2018 Feb;19(2):e97-e104
pubmed: 29401139
J Clin Apher. 2023 Apr;38(2):77-278
pubmed: 37017433
Arch Neurol. 2006 Jul;63(7):930-5
pubmed: 16831960