■治疗性血浆置换(TPE)是一种体外治疗方法,可从血浆中去除大分子量物质。在我们的研究中,我们旨在回顾性研究接受TPE的患者的适应症和手术方法,以及手术过程中发生的并发症。
■研究纳入了41例患者,这些患者在2017年至2021年期间在GaziYaargil培训和研究医院的PICU中接受监测,并有TPE适应症。在TPE程序之前和之后检查实验室参数。除了这些,患者诊断,体重,程序类型和设备类型,在那里进行了手术,程序的持续时间,处理的血液和血浆量,并发症,程序的数量,并对手术过程中或独立于手术过程的死亡进行了评估。
■中位年龄为93.0(14.0-167.0)个月。溶血性尿毒综合征(HUS)是最常见的TPE适应症,有9例患者。与TPE相关的最常见并发症是发热(11例),18例患者无并发症发生。当实验室结果根据美国分离术协会(ASFA)类别进行评估时,观察到血小板值的显着改善,AST,ALT,LDH,尿素,TPE后ASFA1和肌酐。在ASFA2中没有观察到显著的改善(p>0.05)。在ASFA3中,观察到INR的显着改善,AST,ALT,LDH,总胆红素,肌酐,pH值,和TPE后的乳酸值(p<0.05)。5例患者死于ASFA1,1例来自ASFA2,3例来自ASFA3。
■由于在败血症-MOF中观察到临床和实验室值的显着调整,属于ASFA3类别,我们认为,在这些疾病的早期治疗中,应在ASFA2或ASFA1类别中进行评估。此外,我们认为MIS-C案例,根据ASFA,它们不属于任何类别,应包含在ASFA2或ASFA3类别中,考虑到我们的TPE结果。
UNASSIGNED: Therapeutic plasma exchange (TPE) is an extracorporeal treatment method that removes large molecular weight substances from plasma. In our study, we aimed to retrospectively examine the indications and procedural methods of the patients who had undergone TPE, and the complications that occurred during the procedure.
UNASSIGNED: Forty-one patients who were monitored in thePICU of Gazi Yaşargil Training and Research Hospital and had indications for TPE between 2017 and 2021 were included in the study. Laboratory parameters were checked before and after the TPE procedure. In addition to these, patients\' diagnosis, weight, type of procedure and type of device, where the procedure was performed, duration of the procedure, amount of blood and plasma processed, complications, number of procedures, and death during the procedure or independent of the procedure were evaluated.
UNASSIGNED: The median age was 93.0 (14.0-167.0) months. Hemolytic uremic syndrome (HUS) was the most common TPE indication with nine patients. The most common complication related to TPE was fever (11 patients), while no complication was observed in 18 patients.When laboratory results were evaluated according to American Society for Apheresis (ASFA) categories, a significant improvement was observed in the values of platelet, AST, ALT, LDH, urea, and creatinine in ASFA1 after TPE. No significant improvement was observed in ASFA2 (p > 0.05). In ASFA3, a significant improvement was observed in INR, AST, ALT, LDH, total bilirubin, creatinine, pH, and lactate values after TPE (p < 0.05). Five patients died from ASFA1, one from ASFA2, and three patients from ASFA3.
UNASSIGNED: Since significant adjustments are observed in clinical and laboratory values in sepsis-MOF, which is in the ASFA3 category, we believe that it should be evaluated in the ASFA2 or ASFA1 category in the early treatment of these diseases. In addition, we think that MIS-C cases, which have not been in any category according to ASFA, should be included in the ASFA2 or ASFA3 category, considering our TPE results.