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Therapeutic plasma exchange: A potential management strategy for critically ill MIS-C patients in the pediatric intensive care unit.
Emeksiz, Serhat; Özcan, Serhan; Perk, Oktay; Uyar, Emel; Çelikel Acar, Banu; Kibar Gül, Ayse Esin; Özkaya Parlakay, Aslinur; Özbek, Namik; Ekici Tekin, Zahide; Coskun, Serkan; Aydin, Fatma; Çelikel, Elif; Kavurt, Ahmet Vedat; Ece, Ibrahim; Ok Bozkaya, Ikbal; Ertürk, Ahmet; Güney, Dogus; Senel, Emrah.
  • Emeksiz S; Ankara Yildirim Beyazit University, Ankara Children's Hospital, Department of Pediatric Intensive Care Unit, Ankara, Turkey. Electronic address: serhatemeksiz@yahoo.com.
  • Özcan S; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Intensive Care, Ankara, Turkey. Electronic address: ozcanserhan32@gmail.com.
  • Perk O; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Intensive Care, Ankara, Turkey. Electronic address: droktayperk@hotmail.com.
  • Uyar E; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Intensive Care, Ankara, Turkey. Electronic address: uyaremel@yahoo.com.
  • Çelikel Acar B; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Rheumatology, Ankara, Turkey. Electronic address: banuacar@gmail.com.
  • Kibar Gül AE; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Cardiology, Ankara, Turkey. Electronic address: dreseresin@yahoo.com.
  • Özkaya Parlakay A; Ankara Yildirim Beyazit University, Ankara Children's Hospital, Department of Pediatric Infectious Diseases, Ankara, Turkey. Electronic address: aslinur.o@gmail.com.
  • Özbek N; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Hematology, Ankara, Turkey. Electronic address: namikyozbek@gmail.com.
  • Ekici Tekin Z; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Rheumatology, Ankara, Turkey. Electronic address: zahide20@hotmail.com.
  • Coskun S; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Rheumatology, Ankara, Turkey. Electronic address: drserkancoskun27@gmail.com.
  • Aydin F; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Rheumatology, Ankara, Turkey. Electronic address: fatma4326@yahoo.com.
  • Çelikel E; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Rheumatology, Ankara, Turkey. Electronic address: elifcelikel06@gmail.com.
  • Kavurt AV; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Cardiology, Ankara, Turkey. Electronic address: vedatkavurt@hotmail.com.
  • Ece I; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Cardiology, Ankara, Turkey. Electronic address: dribrahimece@gmail.com.
  • Ok Bozkaya I; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Hematology, Ankara, Turkey. Electronic address: ikbalok@yahoo.com.
  • Ertürk A; University of Health Sciences, Ankara Children's Hospital, Department of Pediatric Surgery, Ankara, Turkey. Electronic address: drahmeterturk@hotmail.com.
  • Güney D; Ankara Yildirim Beyazit University, Ankara Children's Hospital, Department of Pediatric Surgery, Ankara, Turkey. Electronic address: dous_caliskan@hotmail.com.
  • Senel E; Ankara Yildirim Beyazit University, Ankara Children's Hospital, Department of Pediatric Surgery, Ankara, Turkey. Electronic address: dremrah2000@gmail.com.
Transfus Apher Sci ; 60(3): 103119, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1164555
ABSTRACT
This study aimed to evaluate the effectiveness and the role of therapeutic plasma exchange (TPE) in treatment of children with severe MIS-C. In addition, we assessed demographic data, clinical features, laboratory abnormalities, underlying conditions, treatments, and outcomes. Patients with severe MIS-C who were admitted to the pediatric intensive care unit (PICU) between September 01 and October 05, 2020 were included in this observational, descriptive, retrospective study. The data collected included the patients' demographic data, presenting symptoms, clinical features, laboratory parameters, diagnostic investigations, and medications. Of 27 children with MIS-C, 63 % were male. The median age of the patients was nine years. Intravenous immunoglobulin and corticosteroids were used for treatment in 100 % of the patients, anakinra in 51.8 %, vasopressors in 85.1 %, noninvasive mechanical ventilation in 25.9 %, and invasive mechanical ventilation in 18.5 %. Ten of the 27 patients (37 %) underwent TPE. In the patients who underwent TPE, the median PELOD score was 21 (IQR 11-30.25) before TPE and 10 (IQR 10-11) after TPE (p < 0.001). Moreover, their median left ventricular ejection fraction (LVEF) was 52 % (IQR 49.25 %-55 %) before TPE and median LVEF was 66.5 (IQR 58 %-68.5 %) after TPE (p = 0.012). The median number of TPE sessions was three (IQR 2-4.75). The mortality rate of the patients with severe MIS-C admitted to the PICU was 7.4 %. We suggest that TPE should be considered as a therapeutic option in children with severe MIS-C. Early initiation of TPE followed by immunomodulatory therapy in critically ill children with MIS-C may help improve clinical and laboratory outcomes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Plasma Exchange / Critical Illness / Multiple System Atrophy Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Child / Female / Humans / Male Language: English Journal: Transfus Apher Sci Journal subject: Hematology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Plasma Exchange / Critical Illness / Multiple System Atrophy Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adolescent / Child / Female / Humans / Male Language: English Journal: Transfus Apher Sci Journal subject: Hematology Year: 2021 Document Type: Article