评估在儿科重症监护室接受血浆置换术的患者的疗效。

IF 1.2 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
Turkish Journal of Medical Sciences Pub Date : 2024-03-04 eCollection Date: 2024-01-01 DOI:10.55730/1300-0144.5817
Mehmet Nur Talay, Özhan Orhan, Murat Kanğin, Eşe Eda Turanli, Mehmet Nuri Özbek
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引用次数: 0

摘要

背景/目的:治疗性血浆置换术(TPE)是一种从血浆中清除大分子量物质的体外治疗方法。在我们的研究中,我们旨在回顾性研究接受治疗性血浆置换术(TPE)患者的适应症、手术方法以及手术过程中出现的并发症:研究纳入了 41 名在 2017 年至 2021 年期间在加齐亚萨尔吉尔培训与研究医院重症监护室(PICU)接受监测并有 TPE 适应症的患者。在TPE手术前后检查了实验室参数。除此之外,还评估了患者的诊断、体重、手术类型和设备类型、手术地点、手术持续时间、处理的血液和血浆量、并发症、手术次数以及手术期间或手术之外的死亡情况:中位年龄为 93.0 (14.0-167.0) 个月。溶血性尿毒症(HUS)是最常见的 TPE 适应症,共有 9 名患者。根据美国血液净化协会(ASFA)的分类对实验室结果进行评估后发现,TPE 治疗后,ASFA1 患者的血小板、谷草转氨酶(AST)、谷丙转氨酶(ALT)、低密度脂蛋白胆固醇(LDH)、尿素和肌酐值均有显著改善,ASFA2 患者的血小板、谷草转氨酶(AST)、谷丙转氨酶(ALT)、低密度脂蛋白胆固醇(LDH)、尿素和肌酐值均无显著改善。在 ASFA2 中未观察到明显改善(P > 0.05)。在 ASFA3 中,TPE 后 INR、AST、ALT、LDH、总胆红素、肌酐、pH 值和乳酸值均有明显改善(p < 0.05)。五名患者死于 ASFA1,一名死于 ASFA2,三名死于 ASFA3:结论:由于脓毒症-MOF属于ASFA3类,其临床和实验室值有明显调整,因此我们认为在早期治疗这些疾病时,应将其评估为ASFA2或ASFA1类。此外,考虑到我们的 TPE 结果,我们认为 MIS-C 病例应被纳入 ASFA2 或 ASFA3 类别,因为根据 ASFA,它不属于任何类别。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of the results of the patients who underwent plasmapheresis in the pediatric intensive care unit.

Background/aim: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

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来源期刊
Turkish Journal of Medical Sciences
Turkish Journal of Medical Sciences 医学-医学:内科
CiteScore
4.60
自引率
4.30%
发文量
143
审稿时长
3-8 weeks
期刊介绍: Turkish Journal of Medical sciences is a peer-reviewed comprehensive resource that provides critical up-to-date information on the broad spectrum of general medical sciences. The Journal intended to publish original medical scientific papers regarding the priority based on the prominence, significance, and timeliness of the findings. However since the audience of the Journal is not limited to any subspeciality in a wide variety of medical disciplines, the papers focusing on the technical  details of a given medical  subspeciality may not be evaluated for publication.
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