Abstract
Background: Therapeutic plasma exchange (TPE) represents a highly effective extracorporeal procedure for selected indications. It is rarely used in children due to safety concerns such as difficult vascular access, low plasma volume and lack of experienced personnel. In this study, we reviewed the TPE indications, the complications we encountered, and the treatment results in critically ill children.
Methods: In this study, 46 pediatric patients who underwent TPE in the pediatric intensive care were evaluated retrospectively.
Results: Total of 2142 patients were hospitalized over a 3-year period, and TPE was applied to 46 (2.1%) patients. TPE was performed most frequently in hematological diseases (26 patients, 56%), and neurological diseases (9 patients, 20%). While 15 patients were classified as ASFA category I, one patient as category II, 25 patients as category III, and 5 patients could not be classified. TPE was also applied to FIRES and transverse myelitis patients who were not included in the ASFA category. The best response was obtained in hematological diseases. Minor complications were observed in 19 (7%) procedures. There were no serious side effects or deaths associated with TPE in any of the patients.
Conclusion: TPE appears to be safe in this study, which detected no significant adverse events or deaths linked to it. TPE was also applied to patients not included in the ASFA category, such as FIRES and TM. ASFA criteria may need to be revised as the number of centers performing TPE and the number of experiences increases.
Keywords
- American Apheresis Association guideline
- Children
- Pediatric Intensive Care
- Therapeutic Plasma Exchange
- Thrombotic Microangiopathy