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Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center

Background: Therapeutic plasma exchange (TPE) is frequently performed in critical care settings for heterogenous indications. However, specific intensive care unit (ICU) data regarding TPE indications, patient characteristics and technical details are sparse. Methods: We performed a retrospective, s...

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Autores principales: Ring, Alexander, Sieber, Wolfgang Alexander, Studt, Jan-Dirk, Schuepbach, Reto A., Ganter, Christoph Camille, Manz, Markus Gabriel, Müller, Antonia Maria Susanne, David, Sascha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141205/
https://www.ncbi.nlm.nih.gov/pubmed/37109212
http://dx.doi.org/10.3390/jcm12082876
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author Ring, Alexander
Sieber, Wolfgang Alexander
Studt, Jan-Dirk
Schuepbach, Reto A.
Ganter, Christoph Camille
Manz, Markus Gabriel
Müller, Antonia Maria Susanne
David, Sascha
author_facet Ring, Alexander
Sieber, Wolfgang Alexander
Studt, Jan-Dirk
Schuepbach, Reto A.
Ganter, Christoph Camille
Manz, Markus Gabriel
Müller, Antonia Maria Susanne
David, Sascha
author_sort Ring, Alexander
collection PubMed
description Background: Therapeutic plasma exchange (TPE) is frequently performed in critical care settings for heterogenous indications. However, specific intensive care unit (ICU) data regarding TPE indications, patient characteristics and technical details are sparse. Methods: We performed a retrospective, single-center study using data from January 2010 until August 2021 for patients treated with TPE in an ICU setting at the University Hospital Zurich. Data collected included patient characteristics and outcomes, ICU-specific parameters, as well as apheresis-specific technical parameters and complications. Results: We identified n = 105 patients receiving n = 408 TPEs for n = 24 indications during the study period. The most common was thrombotic microangiopathies (TMA) (38%), transplant-associated complications (16.3%) and vasculitis (14%). One-third of indications (35.2%) could not be classified according to ASFA. Anaphylaxis was the most common TPE-related complication (6.7%), while bleeding complications were rare (1%). The median duration of ICU stay was 8 ± 14 days. Ventilator support, renal replacement therapy or vasopressors were required in 59 (56.2%), 26 (24.8%), and 35 (33.3%) patients, respectively, and 6 (5.7%) patients required extracorporeal membrane oxygenation. The overall hospital survival rate was 88.6%. Conclusion: Our study provides valuable real-world data on heterogenous TPE indications for patients in the ICU setting, potentially supporting decision-making.
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spelling pubmed-101412052023-04-29 Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center Ring, Alexander Sieber, Wolfgang Alexander Studt, Jan-Dirk Schuepbach, Reto A. Ganter, Christoph Camille Manz, Markus Gabriel Müller, Antonia Maria Susanne David, Sascha J Clin Med Article Background: Therapeutic plasma exchange (TPE) is frequently performed in critical care settings for heterogenous indications. However, specific intensive care unit (ICU) data regarding TPE indications, patient characteristics and technical details are sparse. Methods: We performed a retrospective, single-center study using data from January 2010 until August 2021 for patients treated with TPE in an ICU setting at the University Hospital Zurich. Data collected included patient characteristics and outcomes, ICU-specific parameters, as well as apheresis-specific technical parameters and complications. Results: We identified n = 105 patients receiving n = 408 TPEs for n = 24 indications during the study period. The most common was thrombotic microangiopathies (TMA) (38%), transplant-associated complications (16.3%) and vasculitis (14%). One-third of indications (35.2%) could not be classified according to ASFA. Anaphylaxis was the most common TPE-related complication (6.7%), while bleeding complications were rare (1%). The median duration of ICU stay was 8 ± 14 days. Ventilator support, renal replacement therapy or vasopressors were required in 59 (56.2%), 26 (24.8%), and 35 (33.3%) patients, respectively, and 6 (5.7%) patients required extracorporeal membrane oxygenation. The overall hospital survival rate was 88.6%. Conclusion: Our study provides valuable real-world data on heterogenous TPE indications for patients in the ICU setting, potentially supporting decision-making. MDPI 2023-04-14 /pmc/articles/PMC10141205/ /pubmed/37109212 http://dx.doi.org/10.3390/jcm12082876 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ring, Alexander
Sieber, Wolfgang Alexander
Studt, Jan-Dirk
Schuepbach, Reto A.
Ganter, Christoph Camille
Manz, Markus Gabriel
Müller, Antonia Maria Susanne
David, Sascha
Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center
title Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center
title_full Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center
title_fullStr Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center
title_full_unstemmed Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center
title_short Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center
title_sort indications and outcomes of patients receiving therapeutic plasma exchange under critical care conditions: a retrospective eleven-year single-center study at a tertiary care center
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10141205/
https://www.ncbi.nlm.nih.gov/pubmed/37109212
http://dx.doi.org/10.3390/jcm12082876
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