Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 25 , ISSUE 10 ( October, 2021 ) > List of Articles

Pediatric Critical Care

Therapeutic Plasma Exchange in Pediatric Intensive Care Unit: A Single-center Experience

Serkan Özsoylu, Adem Dursun, Binnaz Çelik

Citation Information : Özsoylu S, Dursun A, Çelik B. Therapeutic Plasma Exchange in Pediatric Intensive Care Unit: A Single-center Experience. Indian J Crit Care Med 2021; 25 (10):1189-1192.

DOI: 10.5005/jp-journals-10071-23985

License: CC BY-NC 4.0

Published Online: 21-06-2022

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: To examine the clinical characteristics, indications, and complications of patients undergoing therapeutic plasma exchange (TPE) in our pediatric intensive care unit (PICU). Materials and methods: 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. Results: 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. Conclusion: 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.


HTML PDF Share
  1. Cortina G, Ojinaga V, Giner T, Riedl M, Waldegger S, Rosales A, et al. Therapeutic plasma exchange in children: one center's experience. J Clin Apher 2017;32(6):494–500. DOI: 10.1002/jca.21547.
  2. Cortina G, McRae R, Chiletti R, Butt W. Therapeutic plasma exchange in critically ill children requiring intensive care. Pediatr Crit Care Med 2018;19(2):97–104. DOI: 10.1097/PCC.0000000000001400.
  3. Nguyen TC, Kiss JE, Goldmann JR, Carcillo JA. The role of plasmapheresis in critical illness. Crit Care Clin 2012;28(3):453–468. DOI: 10.1016/j.ccc.2012.04.009.
  4. Padmanabhan A, Connelly-Smith L, Aqui N, Balogun RA, Klingel R, Meyer E, et al. Guidelines on the use of therapeutic apheresis in clinical practice-evidence- based approach from the writing Committee of the American Society for apheresis: the eighth special issue. J Clin Apher 2019;34(3):171–354. DOI: 10.1002/jca.21705.
  5. Tekgunduz SA, Kara A, Bozkaya IO, Caglı A, Ozbek NY. Therapeutic plasma exchange in non-hematooncological disorder in pediatrics: a single center experience. Transfus Apher Sci 2018;57(1):20–22. DOI: 10.1016/j.transci.2018.02.010.
  6. Paglialonga F, Schmitt CP, Shroff R, Vondrak K, Aufricht C, Watson AR, et al. Indications, technique, and outcome of therapeutic apheresis in European pediatric nephrology units. Pediatr Nephrol 2015;30(1): 103–111. DOI: 10.1007/s00467-014-2907-3.
  7. Hunt EA, Jain NG, Somers MJ. Apheresis therapy in children: an overview of technical aspects and a review of experience in pediatric renal disease. J Clin Apher 2013;28(1):36–47. DOI: 10.1002/jca.21260.
  8. Witt V, Stegmayr B, Ptak J, Wikström B, Berlin G, Axelsson CG, et al. World apheresis registry data from 2003 to 2007, the pediatric and adoplescent side of the registry. Transfus Apher Sci 2008;39(3): 255–260. DOI: 10.1016/j.transci.2008.09.001.
  9. Sık G, Demirbuga A, Annayev A, Akcay A, Çıtak A, Öztürk G. Therapeutic plasma exchange in pediatric intensive care: Indications, results and complications. Ther Apher Dial 2020;24(2):221–229. DOI: 10.1111/1744-9987.13474.
  10. Demirkol D, Karacabey BN, Aygun F. Plasma exchange treatment in a case of colchicine intoxication. Ther Apher Dial 2015;19(1):95–97. DOI: 10.1111/1744-9987.12226.
  11. Schwartz J, Padmanabha A, Aqui N, Balogun RA, Connelly-Smith L, Delaney M, et al. Guidelines on the use of therapeutic apheresis in clinical practice – evidence-based approach from the writing committee of the American Society for Apheresis: the seventh special ıssue. J Clin Apher 2016;31(3):149–62. DOI: 10.1002/jca.21470.
  12. Hadem J, Hafer C, Schneider AS, Wiesner O, Beutel G, Fuehner T, et al. Therapeutic plasma exchange as rescue therapy in severe sepsis and septic shock: retrospective observational single-centre study of 23 patients. BMC Anesthesiol 2014;14:24. DOI: 10.1186/1471-2253-14-24.
  13. De Simone N, Racsa L, Bevan S, Matevosyan K, Valley T, Girod C, et al. Therapeutic plasma exchange in the management of sepsis and multiple organ dysfunction syndrome: a report of three cases. J Clin Apher 2014;29(2):127–131. DOI: 10.1002/jca.21296.
  14. Rimmer E, Houston BL, Kumar A, Abou-Setta AM, Friesen C, Marshall JC, et al. The efficacy and safety of plasma exchange in patients with sepsis and septic shock: a systematic review and meta-analysis. Crit Care 2014;18(6):699. DOI: 10.1186/s13054-014-0699-2.
  15. Qu L, Kiss JE, Dargo G, Carcillo JA. Outcomes of previously healthy pediatric patients with fulminant sepsis-induced multi-system organ failure receiving therapeutic plasma exchange. J Clin Apher 2011;26(4):208–213. DOI: 10.1002/jca.20296.
  16. Kurnaz F, Metan G, Coskun R, Kaynar L, Eser B, Doganay M. A case of Crimean-Congo haemorrhagic fever successfully treated with therapeutic plasma exchange and ribavirin. Trop Doct 2011;41(3): 181–182. DOI: 10.1258/td.2011.100470.
  17. Meço BC, Memikoğlu O, Ilhan O, Ayyıldız E, Gunt C, Unal N, et al. Double filtration plasmapheresis for a case of Crimean-Congo hemorrhagic fever. Transfus Apher Sci 2013;48(3):331–334. DOI: 10.1016/j.transci.2013.04.011.
  18. Beştepe Dursun Z, Korkmaz S, Türe Z, Kaynar L, Dursun A, Çelik İ. Efficacy of therapeutic plasma exchange in patients with Crimean-Congo hemorrhagic fever. J Clin Apher 2021;36(3):390–397. DOI: 10.1002/jca.21875.
  19. Kara A, Turgut S, Cagli A, Sahin F, Oran E, Tunc B. Complications of therapeutic apheresis in children. Transfus Apher Sci 2013;48(3): 375–376. DOI: 10.1016/j.transci.2013.04.020.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.