Uso de plasmaféresis en unidades de pacientes críticos / Indications, adverse effects and results of plasmapheresis in critical care patients
Rev. méd. Chile
; 133(12): 1441-1448, dic. 2005. tab
Article
em Es
| LILACS
| ID: lil-428527
Biblioteca responsável:
BR1.1
ABSTRACT
Background:
Plasmapheresis is a therapeutic alternative for diseases in which a "humoral factor" has pathogenetic relevance. However it is not devoid of adverse effects.Aim:
To review the indications, number of procedures, morbidity and clinical evolution of plasmapheresis in critical patients. Patients andMethods:
A retrospective and descriptive study in four intensive care units of an University hospital. The severity of patients was evaluated with APACHE II and SOFA scores.Results:
Twenty patients were studied. The most common indications of plasmapheresis were thrombotic thrombocytopenic purpura (TTP) in 50% of subjects and small vessel vasculitides in 30%. The number of procedures per patient oscillated between 2 and 14 (mean 7.1±3.3). The registered adverse effects were hypocalcemia in 50% of patients, hypotension in 42.1%, coagulopathy in 35%, hypokalemia in 29%, rash in 20%, procedure related infections in 18% and fever in 10%. There was a significant decrease of 17±28% in prothrombin time, after the procedures. Seventy five percent of patients had a favorable evolution. Global mortality rate was 15%. All deaths occurred in patients with TTP and were attributed to the progression of the disease. No death was attributed to the procedure. The initial APACHE II and SOFA scores were 12.4±8.4 and 5.3±2.9, respectively. Both scores decreased after the procedure. Among other therapeutic measures, 15% of the patients received immunosuppressant treatment, 27% were dialyzed and 32% were mechanically ventilated.Conclusions:
The most common indication of plasmapheresis was TTP. Adverse effects were frequent, however there was no procedure related mortality. The global mortality rate was 15% and all deaths occurred in patients with TTP.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
LILACS
Assunto principal:
Púrpura Trombocitopênica Trombótica
/
Plasmaferese
/
Estado Terminal
/
Cuidados Críticos
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
America do sul
/
Chile
Idioma:
Es
Revista:
Rev. méd. Chile
Assunto da revista:
MEDICINA
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Chile
País de publicação:
Chile