TY - JOUR
T1 - Therapeutic plasma exchange in the management of sepsis and multiple organ dysfunction syndrome
T2 - A report of three cases
AU - De Simone, Nicole
AU - Racsa, Lori
AU - Bevan, Scott
AU - Matevosyan, Karén
AU - Valley, Thomas
AU - Girod, Carlos
AU - Sarode, Ravi
PY - 2014/4
Y1 - 2014/4
N2 - Sepsis with multi organ dysfunction syndrome (MODS) is the most common cause of death in patients in noncoronary intensive care units. Currently, there are no specific treatments that reduce mortality in patients with sepsis and MODS. We report three patients who received therapeutic plasma exchange (TPE) for sepsis with MODS who completely recovered. The first patient, a 3-year-old male presented with Methicillin-resistant Staphylococcus aureus-associated respiratory, renal, coagulation, hepatic, and neurologic dysfunction. After 5 TPEs, the patient fully recovered. The second patient was a 36-year-old pregnant female who developed MODS at 22 weeks of gestation. She had developed respiratory, hepatic, renal, cardiovascular, neurologic, and coagulation dysfunction following pneumonia and concurrent urinary tract infection resulting in an intrauterine fetal demise. After 8 TPEs, the patient was discharged home with only mild residual hepatic dysfunction. The third patient, a 50-year-old female with a history of seizure disorder, was found unresponsive in over 100°F heat and diagnosed with Staphylococcus aureus-associated MODS. Her respiratory, coagulation, neurologic, renal, and hepatic systems were affected. The patient underwent 6 TPEs after which she had marked improvement. In conclusion, TPE may be an effective adjunct therapy in MODS by possibly removing toxic mediators and replacing deficient factors using donor plasma. J. Clin. Apheresis 29:127-131, 2014. © 2013 Wiley Periodicals, Inc.
AB - Sepsis with multi organ dysfunction syndrome (MODS) is the most common cause of death in patients in noncoronary intensive care units. Currently, there are no specific treatments that reduce mortality in patients with sepsis and MODS. We report three patients who received therapeutic plasma exchange (TPE) for sepsis with MODS who completely recovered. The first patient, a 3-year-old male presented with Methicillin-resistant Staphylococcus aureus-associated respiratory, renal, coagulation, hepatic, and neurologic dysfunction. After 5 TPEs, the patient fully recovered. The second patient was a 36-year-old pregnant female who developed MODS at 22 weeks of gestation. She had developed respiratory, hepatic, renal, cardiovascular, neurologic, and coagulation dysfunction following pneumonia and concurrent urinary tract infection resulting in an intrauterine fetal demise. After 8 TPEs, the patient was discharged home with only mild residual hepatic dysfunction. The third patient, a 50-year-old female with a history of seizure disorder, was found unresponsive in over 100°F heat and diagnosed with Staphylococcus aureus-associated MODS. Her respiratory, coagulation, neurologic, renal, and hepatic systems were affected. The patient underwent 6 TPEs after which she had marked improvement. In conclusion, TPE may be an effective adjunct therapy in MODS by possibly removing toxic mediators and replacing deficient factors using donor plasma. J. Clin. Apheresis 29:127-131, 2014. © 2013 Wiley Periodicals, Inc.
KW - coagulopathy
KW - fresh frozen plasma
KW - multiple organ dysfunction syndrome
KW - sepsis
KW - therapeutic plasma exchange
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U2 - 10.1002/jca.21296
DO - 10.1002/jca.21296
M3 - Article
C2 - 24000124
AN - SCOPUS:84899114377
SN - 0733-2459
VL - 29
SP - 127
EP - 131
JO - Journal of Clinical Apheresis
JF - Journal of Clinical Apheresis
IS - 2
ER -