Plasma Exchange in Critically Ill Children: A Single-center Experience

Abstract

The aim of this study was to identify demographic and clinical characteristics of patients who were subjected to plasma exchange (PE) at our unit, and to investigate the effect of these factors on treatment outcome and patient prognosis. Methods: Demographic, clinical and laboratory data of patients who were subjected to PE between January 2012 and August 2015 were obtained from the hospital information system, medical records and the records of apheresis unit. Results: Plasma exchange was performed in 40 patients for 168 times throughout the study. The median age of the patients was 9.4 (range: 1.5-17.3) years, with a male/female ratio of 1.35. Of the patients, 47.5% had an underlying disease. The most common comorbidity was malignancy. The most common indication for PE was sepsis-related multiple organ failure (n=19, 47.5%). The mortality rate was higher in patients with an underlying chronic disease, compared to those without (25% and 7.5%, respectively). No life-threatening complication associated with the apheresis procedure was observed. Conclusion: Our results suggest that PE can be safely performed in children. It seems that indication for PE and the presence of underlying diseases are affecting the mortality rate.

Scope, Safety, and Feasibility of Therapeutic Plasma Exchange in Pediatric Intensive Care Unit: A Single-center Experience

“…This is similar to the studies by Haque et al, Weiss et al, and Hans et al where the majority of TPE was for ASFA category I, and the most common indication were TMA. 7 , 9 , 10 In contrast to our study results, ‘Sepsis/MODS’(ASFA category III) was the predominant indication in studies done by Keskin et al, Sik et al and Duyu et al 6 , 11 , 12 A significant portion, specifically two-thirds, of our study population exhibited non-renal indications for TPE. This trend is becoming more acknowledged, as noted by Margabandhu et al 13 …”

Evaluation of the results of the patients who underwent plasmapheresis in the pediatric intensive care unit

“…When TPE indications were examined in pediatric intensive care units (PICU), neurological diseases were in the first place in previous years. However, it is now more frequently applied in cases of sepsis-related multi-organ failure (sepsis-MOF) [ 4 , 5 ]. The ASFA criteria classify sepsis-MOF cases under category 3 (diseases for which the optimal role cannot be definitively determined).…”