Clinical effect of high-titer plasma in the treatment of severe viral pneumonia in children / 中华急诊医学杂志

ABSTRACT

Objective:To explore the clinical effect of high-titer plasma in the treatment of severe viral pneumonia in children.Methods:A total of 80 eligible children with severe viral pneumonia in intensive care unit of Guangzhou Women and Children Medical Center were enrolled in this retrospective study from January 2016 to June 2019, According to whether high-titer plasma was used or not, patients were divided into the high-titer plasma group (40 cases) and non-high-titer plasma group (40 cases). Chi-square test, Fisher's exact probability test and Mann-Whitney U test were used to compare the basic data, infection indicators, blood gas and ventilator parameters related indicators, treatment and prognosis of the two groups. Results:There were no significant differences in age, sex, admission weight, onset days and fever days between the high-titer plasma group and non-high- titer plasma group before entering the study (all P>0.05); There were no significant differences in the worst SOFA score, Murray lung injury score, chest X-ray involvement and sepsis within 3 days (all P>0.05). There were no significant differences in white blood cells, neutrophils and c-reactive protein between the two groups before and after entering the study (day 3 and 7) (all P> 0.05). There were no significant differences in arterial partial pressure of oxygen (PaO 2), partial pressure of carbon dioxide (PaCO 2), lactic acid (Lac), mean airway pressure (MAP), oxygenation index (P/F) and oxygen index (OI) between the two groups before and after entering the study (day 1, 3 and 7) (all P>0.05). There were no significant differences in the use of immunoglobulin, hormone, fiberoptic bronchoscope, blood purification, high frequency ventilator, pulmonary surfactant and extracorporeal membrane between the two groups (all P>0.05). There were no statistical differences in the number of days using invasive ventilator, the number of days staying in PICU and the total length of hospital stay between the two groups (all P>0.05). There was shorter time of the body temperature decreased to normal time in the high-titer plasma group than in the non-high-titer plasma group ( Z=-2.10, P=0.04). The survival rate of the high-titer plasma group was higher than that of the non-high-titer plasma group (85% vs 65%, χ2=4.27, P=0.04). The average daily cost of the high-titer plasma group was less than that of the non-high-titer plasma group, 3 688.38 yuan (2 335.49, 5 741.51) yuan vs 3 979.24 yuan (2 670.68, 9 992.62) yuan, but the difference was not statistically significant (Z=-1.35, P=0.18). No serious adverse reactions were observed during the treatment with high-titer plasma. Conclusions:The treatment of severe viral pneumonia with high-titer plasma can shorten fever time and improve survival rate. High-titer plasma can be used as a safe and effective treatment for severe viral pneumonia.