Department of Neurology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
Department of Neurology, Bumrungrad International Hospital and Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Clin Apher. 2021 Dec;36(6):849-863. doi: 10.1002/jca.21937. Epub 2021 Oct 25.
Therapeutic plasma exchange (TPE) for neuroimmunological disorders has played an increasingly important role within the Southeast Asian (SEA) region. The South East Asian Therapeutic Plasma exchange Consortium (SEATPEC) was formed in 2018 to promote education and research on TPE within the region. The advent of the Covid-19 pandemic has produced challenges for the development and expansion of this service.
A qualitative and semi-quantitative questionnaire-based survey was conducted by SEATPEC member countries from January to June 2020 (Phase 1) and then from July 2020 to January 2021 in (Phase 2) to assess the impact of Covid-19 on regional TPE.
The study's main objectives were to explore the challenges experienced and adaptations/adjustments taken by SEATPEC countries in order to continue safe and efficient TPE during the Covid-19 pandemic.
The pandemic was found to disrupt the delivery of TPE services in all SEATPEC countries. Contributing factors were multifactorial due to overstretched medical services, staff shortages, quarantines and redeployments, fear of acquiring Covid-19, movement restriction orders, and patient's psychological fear of attending hospitals/testing for Covid-19. All SEATPEC countries practiced careful stratification of cases for TPE (electives vs emergencies, Covid-19 vs non-Covid-19 cases). SEATPEC countries had to modify TPE treatment protocols to include careful preprocedure screening of patient's for Covid-19, use of personal protective equipment (PPE) and post-TPE sanitization of machines and TPE suites.
Based on the responses of the survey, SEATPEC countries produced a consensus statement with five recommendations for safe and effective TPE within the region.
在东南亚（SEA）地区，治疗性血浆置换（TPE）在神经免疫性疾病中的应用发挥了越来越重要的作用。东南亚治疗性血浆交换协会（SEATPEC）成立于 2018 年，旨在促进该地区 TPE 的教育和研究。新冠疫情的爆发给该服务的发展和扩大带来了挑战。
SEATPEC 成员国于 2020 年 1 月至 6 月（第一阶段）和 2020 年 7 月至 2021 年 1 月（第二阶段）进行了一项基于定性和半定量问卷的调查，以评估新冠疫情对区域 TPE 的影响。
本研究的主要目的是探讨 SEATPEC 国家在新冠疫情期间为继续进行安全有效的 TPE 而面临的挑战和采取的适应/调整措施。
研究发现，新冠疫情打乱了所有 SEATPEC 国家 TPE 服务的提供。由于医疗服务紧张、人员短缺、隔离和重新部署、担心感染新冠病毒、出行限制令以及患者对前往医院进行新冠病毒检测的心理恐惧等多种因素，导致 TPE 服务受到干扰。所有 SEATPEC 国家都对 TPE 病例进行了仔细的分层（选择性与紧急性、新冠病例与非新冠病例）。SEATPEC 国家不得不修改 TPE 治疗方案，包括仔细筛查患者的新冠病毒感染情况，使用个人防护设备（PPE），以及 TPE 机器和 TPE 套房的使用后消毒。
根据调查的回复，SEATPEC 国家达成了一项共识声明，提出了五项在该地区进行安全有效的 TPE 的建议。
