Özsoylu Serkan, Dursun Adem, Çelik Binnaz
Department of Pediatric Intensive Care, Kayseri City Education and Research Hospital, Kayseri, Turkey.
Indian J Crit Care Med. 2021 Oct;25(10):1189-1192. doi: 10.5005/jp-journals-10071-23985.
To examine the clinical characteristics, indications, and complications of patients undergoing therapeutic plasma exchange (TPE) in our pediatric intensive care unit (PICU).
Patients who underwent therapeutic plasma exchange between January 2018 and January 2020 in the PICU were included in the study. Demographic, clinical, and laboratory data of patients were obtained retrospectively from medical records. A venous catheter was placed into subclavian, femoral, or jugular veins. The number of plasmapheresis sessions for each patient was determined by observing the course of the disease and clinical improvement. Patients were monitored for vital signs during the plasmapheresis process. Complications directly associated with TPE were recorded.
During the 2-year study period, 105 TPE sessions were performed in 25 patients (15 males/10 females). The median age was 84 months (6-204), and the median body weight was 32 kg (8-75). Renal disorders and sepsis were the most common group, and about 48% of patients were in these groups. The most common diagnoses were sepsis with multi-organ dysfunction syndrome in seven patients and followed by hemolytic uremic syndrome (five patients) and Guillain-Barre syndrome (three patients). Nausea (6.7%) and hypocalcemia (6.7%) were the most common complications of patients associated with the procedure. Premature discontinuation of the procedure were not seen due to complications. Complications were treated with symptomatic therapy.
TPE is an effective treatment that can be safely used for pediatric patients with developments in PICUs. Nevertheless, TPE should be performed by experienced staff at a specialized center to minimize the risk of complications.
Özsoylu S, Dursun A, elik B Therapeutic Plasma Exchange in Pediatric Intensive Care Unit: A Single-center Experience. Indian J Crit Care Med 2021;25(10):1189-1192.
研究我院儿科重症监护病房(PICU)接受治疗性血浆置换(TPE)患者的临床特征、适应证及并发症。
纳入2018年1月至2020年1月在PICU接受治疗性血浆置换的患者。回顾性收集患者的人口统计学、临床及实验室资料。通过锁骨下静脉、股静脉或颈静脉置入静脉导管。根据病情及临床改善情况确定每位患者的血浆置换次数。血浆置换过程中监测患者生命体征。记录与TPE直接相关的并发症。
在为期2年的研究期间,25例患者(男15例/女10例)共进行了105次TPE治疗。中位年龄为84个月(6 - 204个月),中位体重为32 kg(8 - 75 kg)。肾脏疾病和脓毒症是最常见的组别,约48%的患者属于这两组。最常见的诊断为7例脓毒症伴多器官功能障碍综合征,其次是溶血尿毒综合征(5例)和吉兰 - 巴雷综合征(3例)。恶心(6.7%)和低钙血症(6.7%)是与该操作相关的最常见并发症。未因并发症而提前终止操作。并发症采用对症治疗。
TPE是一种有效的治疗方法,可安全用于PICU中病情进展的儿科患者。然而,TPE应由专业中心的经验丰富人员进行,以尽量降低并发症风险。
Özsoylu S, Dursun A, elik B儿科重症监护病房的治疗性血浆置换:单中心经验。《印度重症医学杂志》2021;25(10):1189 - 1192 。