Loading...
Please wait, while we are loading the content...
Similar Documents
Use of Therapeutic Plasma Exchange in Children With Thrombocytopenia-Associated Multiple Organ Failure in the Turkish Thrombocytopenia-Associated Multiple Organ Failure Network
| Content Provider | Scilit |
|---|---|
| Author | Sevketoglu, Esra Yildizdas, Dincer Horoz, Ozden Ozgur Kihtir, Hasan Serdar Kendirli, Tanil Bayraktar, Suleyman Carcillo, Joseph A. |
| Copyright Year | 2014 |
| Description | Journal: Pediatric Critical Care Medicine |
| Abstract | Objective: Thrombocytopenia-associated multiple organ failure can lead to high mortality in critically ill children, possibly related to consequences of thrombotic microangiopathy . Plasma exchange therapy may improve thrombotic microangiopathy . The purpose of this observational cohort study is to describe whether there is an association between use of plasma exchange therapy and outcome in the Turkish thrombocytopenia-associated multiple organ failure network. Setting-Interventions: We performed a retrospective cohort analysis in patients with thrombocytopenia-associated multiple organ failure at three different PICUs comparing those who received plasma exchange (+) plus standard therapies with those who did not receive plasma exchange (–) and only received standard therapies. Results: Among 42 of the enrolled patients with thrombocytopenia-associated multiple organ failure, all had a primary or secondary sepsis diagnosis. Fifteen received plasma exchange therapy (PE [+] group) and 27 received standard medical treatment without plasma exchange (PE [–] group). The mean age was 17.69 months (8.24–54.22) in the PE (+) group and 13.46 months (6.47–20.55) in the PE (–) group. Age (p = 0.232), gender (p = 0.206), thrombocyte count (p = 0.09), Organ Failure Index score (p = 0.111), and pediatric logistic organ dysfunction score (p = 0.177) at admission were not statistically different between groups. The overall 28-day mortality was higher in the PE (–) group (70.37%) compared with the PE (+) group (26.67%) (univariate p = 0.006; multivariate controlling for pediatric logistic organ dysfunction, Organ Failure Index, Pediatric Risk of Mortality scores, and neurological failure p = 0.048). Length of stay was increased in the PE (+) group (p = 0.004). Conclusions: The positive association found between use of plasma exchange therapy and improved survival supports the potential of this therapy in Turkish children with thrombocytopenia-associated multiple organ failure. The positive, although less so, associated treatment effect observed after controlling for illness severity provides further rationale for performing a randomized controlled trial in the pediatric Turkish thrombocytopenia-associated multiple organ failure network. Sample size calculations call for a 100-patient trial with a pre hoc interim analysis after enrollment of 50 patients with thrombocytopenia-associated multiple organ failure. |
| Related Links | http://europepmc.org/articles/pmc5287151?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287151/pdf |
| Ending Page | e359 |
| Page Count | 6 |
| Starting Page | e354 |
| ISSN | 15297535 |
| DOI | 10.1097/pcc.0000000000000227 |
| Journal | Pediatric Critical Care Medicine |
| Issue Number | 8 |
| Volume Number | 15 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2014-10-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Pediatric Critical Care Medicine Critical Care Medicine Disseminated Intravascular Coagulation Thrombocytopenia-associated Multiple Organ Failure Thrombotic Microangiopathy Thrombotic Thrombo Cytopenic Purpura |
| Content Type | Text |
| Resource Type | Article |
| Subject | Critical Care and Intensive Care Medicine Pediatrics, Perinatology and Child Health |
