The Controversy Continues: Whether to Perform Plasma Exchange, and with What Dose of Steroids, in the PEXIVAS Trial

Glassberg, Marilyn K.; Ali, Alissa; Gregorini, Gina

doi:10.1164/rccm.202402-0424ed

Am J Respir Crit Care Med

2024

DOI: 10.1164/rccm.202402-0424ed

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The Controversy Continues: Whether to Perform Plasma Exchange, and with What Dose of Steroids, in the PEXIVAS Trial

Marilyn K. Glassberg,

Alissa Ali,

Gina Gregorini

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2024

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Diffuse alveolar hemorrhage in pediatrics: Etiologies and outcomes

Cohen,

Eisner,

Fussner

et al. 2024

Pediatric Pulmonology

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BackgroundMany conditions, including autoimmune disease and idiopathic pulmonary hemosiderosis (IPH), can cause diffuse alveolar hemorrhage (DAH). Little is known about the epidemiology and outcomes in children.ObjectivesThis retrospective cohort study sought to describe the etiologies and outcomes of DAH in pediatric patients at a tertiary care center.MethodsThis study involved review of patient records with diagnostic codes or bronchoscopy reports suggestive of pulmonary hemorrhage at a large children's hospital over 11 years (2010−2020). Patients were included if they met criteria for DAH, defined as bilateral pulmonary infiltrates and at least one of the following: (1) hemoptysis, (2) blood visible on bronchoscopic exam without apparent airway source, or (3) DAH noted on biopsy or autopsy. Infants less than 10 days corrected gestational age were excluded.ResultsSeventy‐one children with DAH were included in the analysis. Cardiovascular disease was the most common etiology. Bleeding diathesis was common, but all patients had other causes of DAH. Patients with IPH were younger than those with autoimmune disease (p < .001). Most (77%) patients required mechanical ventilation, though this was less common among patients with autoimmune disease. Overall mortality was high (37%) but varied based on underlying etiology; mortality was higher in patients with cardiovascular disease (65%) while no deaths were seen in patients with autoimmune disease or IPH (p = .002). Survivors of DAH who performed pulmonary function tests had normal lung function.ConclusionsDAH frequently causes respiratory failure in children. In our cohort, mortality was highest in patients with cardiovascular disease.

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Diffuse alveolar hemorrhage in pediatrics: Etiologies and outcomes

Cohen,

Eisner,

Fussner

et al. 2024

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

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The Controversy Continues: Whether to Perform Plasma Exchange, and with What Dose of Steroids, in the PEXIVAS Trial

Cited by 1 publication

References 11 publications

Diffuse alveolar hemorrhage in pediatrics: Etiologies and outcomes

Diffuse alveolar hemorrhage in pediatrics: Etiologies and outcomes

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