Uso de plasmaféresis en unidades de pacientes críticos

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 pat...

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Autores principales:	Benítez G,Carlos, Andresen,Max, Farías G,Gonzalo, Castillo S,Carmen, Henríquez V,Mauricio, Pereira,Jaime
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Plasmapheresis Purpura thrombocytopenic Vasculitis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200005
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spelling	oai:scielo:S0034-988720050012000052006-01-27Uso de plasmaféresis en unidades de pacientes críticosBenítez G,CarlosAndresen,MaxFarías G,GonzaloCastillo S,CarmenHenríquez V,MauricioPereira,Jaime Plasmapheresis Purpura thrombocytopenic Vasculitis 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 and Methods: 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 (Rev Méd Chile 2005; 133: 1441-48)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.12 20052005-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200005es10.4067/S0034-98872005001200005
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Plasmapheresis Purpura thrombocytopenic Vasculitis
spellingShingle	Plasmapheresis Purpura thrombocytopenic Vasculitis Benítez G,Carlos Andresen,Max Farías G,Gonzalo Castillo S,Carmen Henríquez V,Mauricio Pereira,Jaime Uso de plasmaféresis en unidades de pacientes críticos
description	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 and Methods: 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 (Rev Méd Chile 2005; 133: 1441-48)
author	Benítez G,Carlos Andresen,Max Farías G,Gonzalo Castillo S,Carmen Henríquez V,Mauricio Pereira,Jaime
author_facet	Benítez G,Carlos Andresen,Max Farías G,Gonzalo Castillo S,Carmen Henríquez V,Mauricio Pereira,Jaime
author_sort	Benítez G,Carlos
title	Uso de plasmaféresis en unidades de pacientes críticos
title_short	Uso de plasmaféresis en unidades de pacientes críticos
title_full	Uso de plasmaféresis en unidades de pacientes críticos
title_fullStr	Uso de plasmaféresis en unidades de pacientes críticos
title_full_unstemmed	Uso de plasmaféresis en unidades de pacientes críticos
title_sort	uso de plasmaféresis en unidades de pacientes críticos
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001200005
work_keys_str_mv	AT benitezgcarlos usodeplasmaferesisenunidadesdepacientescriticos AT andresenmax usodeplasmaferesisenunidadesdepacientescriticos AT fariasggonzalo usodeplasmaferesisenunidadesdepacientescriticos AT castilloscarmen usodeplasmaferesisenunidadesdepacientescriticos AT henriquezvmauricio usodeplasmaferesisenunidadesdepacientescriticos AT pereirajaime usodeplasmaferesisenunidadesdepacientescriticos
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Uso de plasmaféresis en unidades de pacientes críticos

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