Utility and safety of plasma exchange in paediatric neuroimmune disorders
Utility and safety of plasma exchange in paediatric neuroimmune disorders
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DOI：
10.1111/dmcn.14150
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发表时间：
2019-05-01
影响因子：
3.8
通讯作者：
Hemingway, Cheryl
中科院分区：
文献类型：
--
作者：
Eyre, Michael;Hacohen, Yael;Hemingway, Cheryl
AimOur的目的是确定的适应症，副作用，并在儿童接受治疗性血浆置换（TPE）为neurological disorders.MethodMedical记录进行回顾性分析，为58个连续的儿童（年龄16岁）在四个三级中心进行67个疗程的TPE。患者的特点，治疗时间表，并发症，和outcomes进行了analysed.ResultsMedian年龄在开始TPE是9年（范围1- 15年）。适应症包括周围神经系统（PNS; n=18）和中枢神经系统（CNS; n=40）疾病。课程包括8天（范围3-466）内的6次交流（范围2-179）。在开始时，58名儿童中有42名（73%）严重残疾（卧床不起），58名儿童中有24名（41%）被送入重症监护室。治疗临床医生的反应印象是积极的，16/18的PNS疾病与22/40的CNS疾病（p=0.016）。在完成TPE时，58名儿童中有13名（22%）的残疾（改良兰金量表）得到改善（p=0.003）。并发症发生在40/67例（60%）疗程中，其中16/67例（24%）与线路相关。潜在的危及生命的并发症发生在2的67（3%）courses.InterpretationThis队列研究提供了临床医生和家庭的安全性和有效性信息，并为未来的前瞻性研究的基础。
AimOur aim was to ascertain the indications, side effects, and outcomes in children receiving therapeutic plasma exchange (TPE) for neurological disorders.MethodMedical records were retrospectively reviewed for 58 consecutive children (age 16y) undergoing 67 courses of TPE across four tertiary centres. Patient characteristics, treatment schedules, complications, and outcomes were analysed.ResultsMedian age at initiation of TPE was 9years (range 1-15y). Indications included peripheral nervous system (PNS; n=18) and central nervous system (CNS; n=40) disorders. Courses comprised a median six exchanges (range 2-179) over 8days (range 3-466). Forty-two out of 58 (73%) children were severely disabled (bedridden) at initiation and 24 out of 58 (41%) were admitted to intensive care units. Treating clinicians' impression of response was positive in 16 out of 18 of those with PNS disorders versus 22 out of 40 with CNS disorders (p=0.016). Improvements in disability (modified Rankin Scale) occurred in 13 out of 58 (22%) children by completion of TPE (p=0.003). Complications occurred in 40 out of 67 (60%) courses, of which 16 out of 67 (24%) were line related. Potentially life-threatening complications occurred in 2 out of 67 (3%) courses.InterpretationThis cohort study provides safety and efficacy information for clinicians and families and a basis for future prospective studies.