Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct;70(5):332-335.
doi: 10.5455/medarh.2016.70.332-335. Epub 2016 Oct 25.

Plasmapheresis in Pediatric Intensive Care Unit

Verica Misanovic  1 , Danka Pokrajac  1 , Smail Zubcevic  1 , Admir Hadzimuratovic  1 , Samra Rahmanovic  1 , Selma Dizdar  1 , Asmir Jonuzi  2 , Edin Begic  3
Affiliations

Plasmapheresis in Pediatric Intensive Care Unit

Verica Misanovic et al. Med Arch. 2016 Oct.

Abstract

Introduction: Plasmapheresis also known as a therapeutic plasma exchange (TPE) is extracorporeal procedure by which individual components of plasma that are harmful or blood cells can be removed from organism by using a blood separation technology.

Aim: To present the results of the implementation of plasmapheresis in children in the Department of Pediatric Intensive Care of Pediatric Clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina.

Patients and methods: Research (period from December 2011 to June 2016) analyzed 66 plasmapheresis (11 patients-6 plasmapheresis per patient).

Results: Out of 11 patients, 7 (63.6%) were girls and 4 (36.4%) were boys. The average age of patients was 11.6 ± 3.9 years (the youngest patient had 4 years and 7 months, while the oldest had 16 years and 10 months). Plasmapheresis were significantly more often done in the winter and summer. Underlying disease was in 54.5% of cases of neurological origin. The treatment was in form of receiving IVIG in 7 patients, or the application of mechanical ventilation in 6 patients. The most common complication was hypotension, which occurred in 45.5% of patients, followed by bleeding in 36.3%, hypercoagulability in 27.2% of patients and hematoma in 27.2% of patients. Lethal outcome occurred in 3 (27.2%) patients.

Conclusion: Plasmapheresis represents an invasive method due to need for placement of centralized venous catheter that provides adequate blood flow during the procedure. Although complications can be serious, they are rare and are mainly related to the presence of central venous catheter, hemostasis disorders due to use of anticoagulant therapy, and hypotension of the cardiovascular system. It should be noted that for success of plasmapheresis in children multidisciplinary approach is necessary (children's nephrologist, neuropediatrician, intensive care doctor) as well as well-trained team of doctors and nurses with the acquired knowledge and skills.

Keywords: complications; indications; plasmapheresis.

PubMed Disclaimer

Conflict of interest statement

• Conflict of interest: none declared.

Figures

Figure 1
Figure 1
Patients place of living
Figure 2
Figure 2
Corelation between number of patients and number of plasmapheresis
Figure 3
Figure 3
Underlying disease of patient
Figure 4
Figure 4
Number of complications
Figure 5
Figure 5
Treatment result
See this image and copyright information in PMC

References

    1. Woźniak K, Urbanowska E, Snarski E. Plasmapheresis in haematology. Wiad Lek. 2015;68(2):173–8. - PubMed
    1. Kes P. Indikacije. In: Kes P, editor. Kontinuirano nadomještanje bubrežne funkcije. Hospal: Zagreb; 2002. pp. 18–24.
    1. Kaplan AA. Therapeutic plasma excange core curriculum 2008. Am J Kidney Dis. 2008;52:1180. - PubMed
    1. Clark WF, Rock GA, Buskard N, Shumak KH, LeBlond P, Anderson D, et al. Therapeutic plasmma exchange: an update from the Canadian Apheresis Group. Ann Intern Med. 1999;131:453–62. - PubMed
    1. Shaz BH, Linenberger ML, Bandarenko N, Winters JL, Kim HC, Marques MB, et al. Category IV indications for therapeutic apheresis: ASFA fourth special issue. J Clin Apher. 2007;22:176. - PubMed

LinkOut - more resources