Outcomes of previously healthy pediatric patients with fulminant sepsis-induced multisystem organ failure receiving therapeutic plasma exchange

2011 ◽  
Vol 26 (4) ◽  
pp. 208-213 ◽  
Author(s):  
Lirong Qu ◽  
Joseph E. Kiss ◽  
Gina Dargo ◽  
Joseph A. Carcillo
Keyword(s):  
Organ Failure ◽  
Plasma Exchange ◽  
Pediatric Patients ◽  
Therapeutic Plasma Exchange ◽  
Multisystem Organ Failure

The use of therapeutic plasma exchange for pediatric patients supported on extracorporeal membranous oxygenator therapy: A narrative review

Perfusion ◽  
2020 ◽  
pp. 026765912097432
Author(s):  
Reut Kassif Lerner ◽  
Uri Pollak
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Organ Failure ◽  
Plasma Exchange ◽  
English Language ◽  
Pediatric Patients ◽  
Multiple Organ ◽  
Therapeutic Plasma Exchange ◽  
Cochrane Library ◽  
Membrane Oxygenation ◽  
Life Saving

Therapeutic plasma exchange in children is increasingly recognized as a life-saving treatment and is challenged by some technical considerations. As extracorporeal membrane oxygenation has been used for nearly half a century for refractory reversible respiratory and/or cardiac failure in both pediatric and adult populations, it may serve as an extracorporeal platform for therapeutic plasma exchange. It is most commonly described in patients with sepsis with multiple organ failure or thrombocytopenia associated multi organ failure. Additional pathophysiological processes of inflammatory and immunological storms might benefit from the combination of extracorporeal membrane oxygenation and plasma exchange. This is a nonmethodological review of English-language reports of therapeutic plasma exchange performed in patients supported by extracorporeal membrane oxygenation, both pediatric and adult, searching six databases, MEDLINE, Clinical Key, GOOGLE SCHOLAR, CINAHL, Cochrane library, and EMBASE.

Therapeutic Plasma Exchange Application in Children Requires Individual Decision

2020 ◽  
Author(s):  
Gürkan Atay ◽  
Demet Demirkol
Keyword(s):  
Plasma Exchange ◽  
Vascular Access ◽  
Pediatric Patients ◽  
Demyelinating Disease ◽  
Pediatric Intensive Care ◽  
Therapeutic Plasma Exchange ◽  
Transplantation Rejection ◽  
Access Problems ◽  
Uremic Syndrome

AbstractTherapeutic plasma exchange (TPE) is a treatment administered with the aim of removing a pathogenic material or compound causing morbidity in a variety of neurologic, hematologic, renal, and autoimmune diseases. In this study, we aimed to assess the indications, efficacy, reliability, complications, and treatment response of pediatric patients for TPE. This retrospective study analyzed data from 39 patients aged from 0 to 18 years who underwent a total of 172 TPE sessions from January 2015 to April 2018 in a tertiary pediatric intensive care unit. Indications for TPE were, in order of frequency, macrophage activation syndrome (28.2%, n = 11), renal transplantation rejection (15.4%, n = 6), liver failure (15.4%, n = 6), Guillain–Barre's syndrome (15%, n = 6), hemolytic uremic syndrome (7.7%, n = 3), acute demyelinating disease (7.7%, n = 3), septic shock (5.1%, n = 2), and intoxication (5.1%, n = 2). No patient had any adverse event related to the TPE during the procedure. The TPE session was ended prematurely in one patient due to insufficient vascular access and lack of blood flow (2.6%). In the long term, thrombosis due to the indwelling central catheter occurred (5.1%, n = 2). TPE appears to be an effective first-stage or supplementary treatment in a variety of diseases, may be safely used in pediatric patients, and there are significant findings that its area of use will increase. In experienced hands and when assessed carefully, it appears that the rate of adverse reactions and vascular access problems may be low enough to be negligible.

Centrifugal Therapeutic Plasma Exchange in Pediatric Patients

2021 ◽  
Author(s):  
Rekha Hans ◽  
Karalanglin Tiewsoh ◽  
Divjot Singh Lamba ◽  
Lesa Dawman ◽  
Satya Prakash ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Pediatric Patients ◽  
Therapeutic Plasma Exchange

Therapeutic Plasma Exchange in Pediatric Patients with Nephrologic Diseases: Results from a Single Center

2017 ◽  
Vol 26 (2) ◽  
Author(s):  
Yaşar Kandur ◽  
Yeşim Özdemir ◽  
Bahar Büyükkaragöz ◽  
Şeniz Göral ◽  
İdil Yenicesu ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Pediatric Patients ◽  
Therapeutic Plasma Exchange ◽  
Single Center

Therapeutic Plasma Exchange in Children With Thrombocytopenia-Associated Multiple Organ Failure

2019 ◽  
Vol 47 (3) ◽  
pp. e173-e181 ◽  
Author(s):  
James D. Fortenberry ◽  
Trung Nguyen ◽  
Jocelyn R. Grunwell ◽  
Rajesh K. Aneja ◽  
Derek Wheeler ◽  
...  
Keyword(s):  
Multiple Organ Failure ◽  
Organ Failure ◽  
Plasma Exchange ◽  
Multiple Organ ◽  
Therapeutic Plasma Exchange

scholarly journals Effects of Therapeutic Plasma Exchange on the Endothelial Glycocalyx in Septic Shock

2021 ◽  
Author(s):  
Klaus Stahl ◽  
Uta Carola Hillebrand ◽  
Yulia Kiyan ◽  
Benjamin Seeliger ◽  
Julius J. Schmidt ◽  
...  
Keyword(s):  
Septic Shock ◽  
Organ Failure ◽  
Plasma Exchange ◽  
Degradation Products ◽  
Ex Vivo ◽  
Fresh Frozen Plasma ◽  
Therapeutic Plasma Exchange ◽  
Endothelial Glycocalyx ◽  
Shock Onset ◽  
Blood Concentrations

Abstract BackgroundDisruption of the endothelial glycocalyx (eGC) is observed in septic patients and its injury is associated with multiple-organ failure and inferior outcomes. Besides this biomarker function, increased blood concentrations of shedded eGC constituents might play a mechanistic role in septic organ failure. We hypothesized that therapeutic plasma exchange (TPE) against fresh frozen plasma might influence eGC related pathology.MethodsWe enrolled 20 norepinephrine dependent (NE > 0.4μg/kg/min) patients with early septic shock (onset < 12h). Sublingual assessment of the eGC via sublingual sidestream darkfield (SDF) imaging was performed. Plasma eGC degradation products such as heparan-sulfate (HS) and the eGC regulating enzymes, heparanase (Hpa)-1 and Hpa-2, were obtained before and after TPE. A 3D microfluidic flow assay was performed to examine the effect of TPE on eGC ex vivo. Results were compared to healthy controls.ResultsSDF demonstrated a marked decrease in eGC thickness in septic patients compared to healthy individuals (p=0.001). Circulating HS levels were increased more than six-fold compared to controls and decreased significantly following TPE (controls: 16.9 (8-18.6) vs. septic patients before TPE: 105.8 (30.8-143.4) μg/ml, p<0.001; vs. after TPE: 70.7 (36.9-109.5) μg/ml, p<0.001). The Hpa-2 /Hpa-1 ratio was markedly reduced in septic patients before TPE but normalized after TPE (controls: 13.6 (6.2-21.2) vs. septic patients at inclusion: 2.9 (2.1-5.7), p=0.001; vs. septic patients after TPE: 13.2 (11.2-31.8), p<0.001). Ex vivo stimulation of endothelial cells with serum from septic patients induced eGC damage that could be attenuated with serum post TPE.ConclusionsSeptic shock results in profound degradation of the eGC and an acquired deficiency of the protective regulator Hpa-2. TPE removed potentially injurious eGC degradation products and partially attenuated Hpa-2 deficiency.Trial registrationclinicaltrials.gov NCT04231994, retrospectively registered 18 January 2020

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