Abstract


Objective: The use of therapeutic plasma exchange (TPE) in pediatric intensive care units (PICUs) has increased in recent years. In this study, we retrospectively report and discuss therapeutic plasmapheresis management in the intensive care unit of a children’s hospital. 

Material and Methods: Demographic, clinical and laboratory data of the patients who were subjected to TPE between 1 January 2016 and 1 June 2018 were obtained from the hospital information system and medical records. 

Results: A total of 190 sessions of therapeutic plasma exchange was performed on 43 patients (Male:Female ratio of 1:1.26). The median age of the patients was 99 months (range 6-214 months). The most common indication was sepsis-related multiple organ failure (n:23, 53.5%). All procedures were conducted using the cell-separator centrifugal method. The ratio of complications during manipulations was 5.7%. No life-threatening complication associated with the therapeutic plasma exchange procedure was observed. The outcome of treatment was complete recovery in 38 (88.4%) patients. 






Conclusion: Therapeutic plasma exchange can be used as an important treatment method in critically ill patients in pediatric intensive care units. The procedure can be safely performed in children. 

Keywords: Children, Plasmapheresis

References

  1. 1. Cortina G, McRae R, Chiletti R, Butt W. Therapeutic plasma exchange
  2. in critically ill children requiring ıntensive care. Pediatr Crit Care Med
  3. 2018;19:97-104.
  4. 2. Schwartz J, Padmanabha A, Aqui N, Balogun RA, Connelly-Smith
  5. L, Delaney M, et al. Guidelines on the use of therapeutic apheresis
  6. in clinical practice - evidence-based approach from the writing
  7. committee of the american society for apheresis: The seventh
  8. special ıssue. J Clin Apher 2016;31:149–62.
  9. 3. Tekgunduz SA, Kara A, Bozkaya IO, Caglı A, Ozbek NY. Therapeutic
  10. plasma exchange in non-hematooncological disorders in pediatrics:
  11. A single center experience. Transfus Apher Sci 2018;58:20-2.
  12. 4. Tolunay İ, Yıldızdaş D, İncecik F, Horoz ÖÖ, Ekinci F, Petmezci
  13. E, et al. Çocuk Yoğun Bakım Ünitemizde Terapötik Plazmaferez
  14. Uygulanan Nörolojik Hastalarımızın Değerlendirilmesi: 10 yıllık
  15. Deneyim. Çocuk acil Yoğun Bakım Dergisi 2015;2:111-14.
  16. 5. Keskin H, Paksu S, Yener N, Köksoy ÖT, Kartal İ, Albayrak C, et
  17. al. Kritik hastalığı olan çocuklarda plazma değişimi: Tek merkez
  18. deneyimi. J Pediatr Emerg Intensive care Med 2018;5:10-4.
  19. 6. Stegmayr BG, Banga R, Berggren L,Norda R, Rydvall A, Vikerfors
  20. T. Plasma exchange as rescue therapy in multiple organ failure
  21. including acute renal failure. Crit Care Med 2003; 31:1730-36.
  22. 7. Sevketoglu E, Yildizdas D, Horoz OO, Kihtir HS, Kendirli T, Bayraktar
  23. S, et al. Use of therapeutic plasma exchange in children with
  24. thrombocytopenia-associated multiple organ failure in the Turkish
  25. thrombocytopenia-associated multiple organ failure network.
  26. Pediatr Crit Care Med 2014;15:354-9.
  27. 8. Kıhtır HS, Yeşilbaş O, Kıhtır Z, Yıldırım HM, Şevketoğlu E. Pediatrik
  28. olanzapin zehirlenmeleri ve bir olguda plazma değişimi uygulaması:
  29. Dört olgu sunumu. Yoğun Bakım Derg 2016;7:34-8.
  30. 9. Nakanishi T, Suzuki N, Kuragano T, Nagasawa Y, Hasiuke Y.
  31. Current topics in therapeutic plasmapheresis. Clin Exp Nephrol
  32. 2014;18:41-9.
  33. 10. Kara A, Turgut S, Cagli A, Sahin F, Oran E, Tunc B. Complications of
  34. therapeutic apheresis in children. Transfus Apher Sci 2013;48:375-
  35. 76.
  36. 11. Szczeklik W, Wawrzycka K, Włudarczyk A, Sega A, Nowak I,
  37. Seczyńska B, et al. Complications in patients treated with plasmapheresis
  38. in the intensive care unit. Anaesthesiol Intensive Ther
  39. 2013;45:7-13.
  40. 12. Sharma RR, Saluja K, Jain A, Dhawan HK, Thakral B, Marwaha
  41. N. Scope and application of therapeutic apheresis: Experience
  42. from a tertiary care hospital in North India. Transfus Apher Sci
  43. 2011;45:239-45.
  44. 13. Yucesan C, Arslan O, Arat M, Yucemen N, Ayyildiz E, Ilhan O, et al.
  45. Therapeutic plasma exchange in the treatment of neuroimmunologic
  46. disorders: Review of 50 cases. Transfus Apher Sci 2007;36:103-7.

Copyright and license

How to cite

1.
Emeksiz S. Our Experience with Therapeutic Plasma Exchange in the Pediatric Intensive Care Unit. Turk J Pediatr Dis [Internet]. 2019 Dec. 23 [cited 2025 May 25];13(6):447-50. Available from: https://turkjpediatrdis.org/article/view/555