scholarly journals Successful Treatment of Thrombocytopenia, Anasarca, Fever, Reticulin Myelofibrosis/Renal Insufficiency, and Organomegaly Syndrome Using Plasma Exchange Followed by Rituximab in the Intensive Care Unit

2021 ◽  
Vol 12 (12) ◽  
pp. 474-480
Author(s):  
Yusuke Otsuka ◽  
Akihiro Shirakabe ◽  
Toshio Asayama ◽  
Hirotake Okazaki ◽  
Yusaku Shibata ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Renal Insufficiency ◽  
Plasma Exchange ◽  
Successful Treatment

scholarly journals Life-threatening COVID-19 presenting as stroke with antiphospholipid antibodies and low ADAMTS-13 activity, and the role of therapeutic plasma exchange: A case series

2020 ◽  
Vol 8 ◽  
pp. 2050313X2096408
Author(s):  
Abdulrahman Alharthy ◽  
Fahad Faqihi ◽  
Abdullah Balhamar ◽  
Ziad A Memish ◽  
Dimitrios Karakitsos
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Plasma Exchange ◽  
Plasma Volume ◽  
Antiphospholipid Antibodies ◽  
Rescue Therapy ◽  
Antiviral Treatment ◽  
Case Series ◽  
Therapeutic Plasma Exchange ◽  
Life Threatening

We present a case series of three patients with COVID-19 who were admitted to our intensive care unit due to acute respiratory distress syndrome, brain infarction, pulmonary embolism, and antiphospholipid antibodies. We applied therapeutic plasma exchange on all cases. On intensive care unit admission, all patients had low (<10) Glasgow Coma Scale, and central nervous imaging showed multiple brain infarctions. COVID-19 was confirmed by reverse transcriptase polymerase chain reaction assays. Patients underwent rescue therapeutic plasma exchange using the Spectra OptiaTM Apheresis System (Terumo BCT Inc., USA), which operates with acid-citrate dextrose anticoagulant as per Kidney Disease Improving Global Outcomes 2019 guidelines. A dose of 1.5 plasma volume was used for the first dose and then 1 plasma volume daily for a total of five doses. Plasma was replaced with Octaplas LG® (Octapharma AG, USA), which is an artificial fresh frozen plasma product that has undergone viral inactivation by prion reduction technology. We administered ARDS-net/prone positioning ventilation, empiric antiviral treatment, therapeutic anticoagulation, and intensive care unit supportive care. Laboratory tests showed lymphocytopenia; elevated levels of D-dimer, fibrinogen, total bilirubin, C-reactive protein, lactate dehydrogenase, and ferritin; as well as low levels of ADAMTS-13 activity and antibody. Serology tests depicted positive IgM and IgG antiphospholipid antibodies (anti-cardiolipin and anti-β2-glycoprotein I antibodies). No side effects of therapeutic plasma exchange were recorded. After the completion of therapeutic plasma exchange, patients improved clinically and gradually recovered neurologically (after 27–32 days). To conclude, in life-threatening COVID-19, especially when immune dysregulation features such as antiphospholipid antibodies exist, therapeutic plasma exchange could be an effective rescue therapy.

scholarly journals Seizures, Metabolic Acidosis and Coma Resulting from Acute Isoniazid Intoxication

2005 ◽  
Vol 33 (4) ◽  
pp. 518-520 ◽  
Author(s):  
I. Topcu ◽  
E. A. Yentur ◽  
A. Kefi ◽  
N. Z. Ekici ◽  
M. Sakarya
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Sodium Bicarbonate ◽  
Successful Treatment ◽  
Ventilatory Support ◽  
Anticonvulsant Therapy ◽  
Dose Equivalent ◽  
Adult Case ◽  
Clinical Triad

Isoniazid is an anti-tuberculosis drug, used commonly for treatment and prophylaxis of tuberculosis. Acute isoniazid intoxication is characterized by a clinical triad consisting of metabolic acidosis resistant to treatment with sodium bicarbonate, seizures which may be fatal and refractory to standard anticonvulsant therapy, and coma. Treatment requires admission to the intensive care unit for ventilatory support, management of seizures and metabolic acidosis. Pyridoxine, in a dose equivalent to the amount of isoniazid ingested, is the only effective antidote. We report the successful treatment of two isoniazid intoxication cases: the case of a child developing an accidental acute isoniazid intoxication and an adult case of isoniazid intoxication with the intent of suicide.

Caring for “Socially Undesirable” Patients

1996 ◽  
Vol 5 (4) ◽  
pp. 500-510 ◽  
Author(s):  
Nancy S. Jecker
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Renal Insufficiency ◽  
Suicide Attempts ◽  
University Hospital ◽  
Healthcare Team ◽  
Local Hospital ◽  
The University ◽  
Osmolar Gap

Mr. Bernard was a homeless man, aged 58. His medical history revealed alcohol abuse, seizure disorder, and two suicide attempts. Brought to the emergency room at a local hospital after being found “semi-comatose,” his respiratory distress led to his being intubated and placed on a ventilator. The healthcare team suspected the patient ingested antifreeze. Transferred from that hospital to the intensive care unit (ICU) of the university hospital, his diagnosis was “high osmolar gap with high-anion gap metabolic acidosis, most likely secondary to ethylene glycol ingestion and renal insufficiency.”

Clinical Applications of Therapeutic Hemapheresis

1996 ◽  
Vol 11 (3) ◽  
pp. 149-161 ◽  
Author(s):  
Sarah Rososhansky ◽  
Irma O. Szymanski
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Plasma Exchange ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Clinical Applications ◽  
Goodpasture's Syndrome ◽  
Thrombocytopenic Purpura ◽  
Technical Aspects ◽  
Prompt Treatment ◽  
Life Saving

Therapeutic hemapheresis may be a life-saving treatment for patients with some diseases, such as thrombotic thrombocytopenic purpura (TTF), Goodpasture's syndrome, and leukemia-induced leukocytosis, among others. Although plasma exchange has been applied for treatment of many conditions, during the last decade a consensus has been reached about the specific but limited number of diseases for which it is of definitive benefit. Some patients are severely ill during the course of the disease, and they require prompt treatment in the intensive care unit. Therapy of these patients is discussed in this review in detail, in addition to technical aspects, indications, contraindications, and complications of therapeutic hemapheresis.

Rumination—A New Complication of Neonatal Intensive Care

PEDIATRICS ◽  
1980 ◽  
Vol 66 (4) ◽  
pp. 551-555
Author(s):  
Thomas G. Sheagren ◽  
Henry H. Mangurten ◽  
Frantz Brea ◽  
Susan Lutostanski
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Treatment Program ◽  
Successful Treatment ◽  
Neonatal Intensive Care ◽  
Care Setting ◽  
Intensive Care Setting ◽  
Rumination Syndrome ◽  
Newborn Intensive Care Unit ◽  
Newborn Intensive Care

The infant rumination syndrome has not been previously reported in a neonatal intensive care setting. We recently managed three infants in our newborn intensive care unit who developed rumination following chronic courses in the unit. The events leading to this condition in each infant are described, as well as the successful treatment program that was instituted. With recognition of factors predisposing to this disorder, the problem may be avoided, providing these infants with the best chance for optimal development despite the need for prolonged intensive care.

Impact of Therapeutic Plasma Exchange on Hemodynamic Parameters in Medical Intensive Care Unit Patients: An Observational Study

2016 ◽  
Vol 41 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Tobias Lahmer ◽  
Marlena Messer ◽  
Christopher Schnappauf ◽  
Sebastian Rasch ◽  
Lisa Fekecs ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Plasma Exchange ◽  
Medical Intensive Care Unit ◽  
Therapeutic Plasma Exchange ◽  
Hemodynamic Parameters ◽  
Medical Intensive Care
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