Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal

Detalhes bibliográficos
Autor(a) principal: Faria, Rita
Data de Publicação: 2022
Outros Autores: Bucur, Alexei, Gordinho, André, Falcão, Luis, Carrão, André, Fernandes, Sara, Colaço, João Pedro, Meneses-Oliveira, Carlos, Messias, António
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14266
Resumo: Introduction: Therapeutic plasmapheresis is a therapeutic procedure in which the patient’s blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit.Material and Methods: An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded.Results: Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresis session due to complications related to the patient.Conclusion: Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.
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spelling Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in PortugalPlasmaferese Terapêutica: Experiência de Sete Anos de um Serviço de Medicina Intensiva em PortugalCritical Illness/therapyPlasma Exchange/methodsPlasmapheresis/adverse effectsPlasmapheresis/methodsPlasmapheresis /therapeutic useEstado Crítico/tratamentoPlasmafere/efeitos adversosPlasmafere/métodosPlasmafere/uso terapêuticoTroca Plasmática/métodosIntroduction: Therapeutic plasmapheresis is a therapeutic procedure in which the patient’s blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit.Material and Methods: An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded.Results: Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresis session due to complications related to the patient.Conclusion: Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.Introdução: A plasmaferese terapêutica é um procedimento em que o sangue passa por um circuito extracorpóreo que separa o plasma dos outros componentes do sangue. O plasma removido é substituído por soluções de reposição. Os estudos sobre a utilização de plasmaferese terapêutica no doente crítico são escassos. O objetivo do estudo foi rever todas as sessões de plasmaferese realizadas no serviço de Medicina Intensiva do Hospital Beatriz Ângelo.Material e Métodos: Estudo observacional retrospetivo de todos os doentes admitidos no serviço de Medicina Intensiva entre abril de 2012 e março de 2019. Foram selecionados os doentes submetidos a plasmaferese e excluídas as sessões realizadas fora do serviço de Medicina Intensiva.Resultados: No período de estudo foram incluídos 46 doentes. A maioria eram homens (n = 29; 63%) com uma idade mediana de 53 anos. Os diagnósticos mais frequentes foram pancreatite secundária a hipertrigliceridemia, vasculite, anemia hemolítica autoimune e síndrome hemolítica urémica atípica. Foram realizadas 198 sessões de plasmaferese no serviço de Medicina Intensiva. As soluções de substituição mais utilizadas foram plasma fresco congelado (34,4%), albumina/cristalóide (24,2%) e albumina/plasma (19,2%). As complicações mais comuns foram alterações hidroeletrolíticas (84; 42,4%), e distúrbios da coagulação/plaquetas (65; 32,8%). Emnenhum dos casos a técnica teve que ser interrompida por complicações relacionadas com o doente.Conclusão: A plasmafere terapêutica é uma técnica complexa que requer treino específico. As indicações são diversas e algumas não consensuais. As complicações foram frequentes, mas não condicionaram morbilidade associada.Ordem dos Médicos2022-03-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14266oai:ojs.www.actamedicaportuguesa.com:article/14266Acta Médica Portuguesa; Vol. 35 No. 3 (2022): March; 176-183Acta Médica Portuguesa; Vol. 35 N.º 3 (2022): Março; 176-1831646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14266https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14266/6415Direitos de Autor (c) 2021 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessFaria, RitaBucur, AlexeiGordinho, AndréFalcão, LuisCarrão, AndréFernandes, SaraColaço, João PedroMeneses-Oliveira, CarlosMessias, António2022-12-20T11:07:10Zoai:ojs.www.actamedicaportuguesa.com:article/14266Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:27.351746Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
Plasmaferese Terapêutica: Experiência de Sete Anos de um Serviço de Medicina Intensiva em Portugal
title Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
spellingShingle Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
Faria, Rita
Critical Illness/therapy
Plasma Exchange/methods
Plasmapheresis/adverse effects
Plasmapheresis/methods
Plasmapheresis /therapeutic use
Estado Crítico/tratamento
Plasmafere/efeitos adversos
Plasmafere/métodos
Plasmafere/uso terapêutico
Troca Plasmática/métodos
title_short Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
title_full Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
title_fullStr Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
title_full_unstemmed Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
title_sort Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal
author Faria, Rita
author_facet Faria, Rita
Bucur, Alexei
Gordinho, André
Falcão, Luis
Carrão, André
Fernandes, Sara
Colaço, João Pedro
Meneses-Oliveira, Carlos
Messias, António
author_role author
author2 Bucur, Alexei
Gordinho, André
Falcão, Luis
Carrão, André
Fernandes, Sara
Colaço, João Pedro
Meneses-Oliveira, Carlos
Messias, António
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Faria, Rita
Bucur, Alexei
Gordinho, André
Falcão, Luis
Carrão, André
Fernandes, Sara
Colaço, João Pedro
Meneses-Oliveira, Carlos
Messias, António
dc.subject.por.fl_str_mv Critical Illness/therapy
Plasma Exchange/methods
Plasmapheresis/adverse effects
Plasmapheresis/methods
Plasmapheresis /therapeutic use
Estado Crítico/tratamento
Plasmafere/efeitos adversos
Plasmafere/métodos
Plasmafere/uso terapêutico
Troca Plasmática/métodos
topic Critical Illness/therapy
Plasma Exchange/methods
Plasmapheresis/adverse effects
Plasmapheresis/methods
Plasmapheresis /therapeutic use
Estado Crítico/tratamento
Plasmafere/efeitos adversos
Plasmafere/métodos
Plasmafere/uso terapêutico
Troca Plasmática/métodos
description Introduction: Therapeutic plasmapheresis is a therapeutic procedure in which the patient’s blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit.Material and Methods: An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded.Results: Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresis session due to complications related to the patient.Conclusion: Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.
publishDate 2022
dc.date.none.fl_str_mv 2022-03-02
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identifier_str_mv oai:ojs.www.actamedicaportuguesa.com:article/14266
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14266
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14266/6415
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2021 Acta Médica Portuguesa
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 35 No. 3 (2022): March; 176-183
Acta Médica Portuguesa; Vol. 35 N.º 3 (2022): Março; 176-183
1646-0758
0870-399X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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