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Titolo:
INTENSIVE BLOOD AND PLASMA-EXCHANGE FOR TREATMENT OF COAGULOPATHY IN MENINGOCOCCEMIA
Autore:
CHURCHWELL KB; MCMANUS ML; KENT P; GORLIN J; GALACKI D; HUMPHREYS D; KEVY SV;
Indirizzi:
CHILDRENS HOSP,MULTIDISCIPLINARY INTENS CARE UNIT,300 LONGWOOD AVE BOSTON MA 02115 CHILDRENS HOSP,MULTIDISCIPLINARY INTENS CARE UNIT BOSTON MA 02115 CHILDRENS HOSP,THERAPEUT APHERESIS CTR BOSTON MA 02115 HARVARD UNIV,SCH MED,DEPT PEDIAT BOSTON MA 00000 HARVARD UNIV,SCH MED,DEPT ANESTHESIA BOSTON MA 00000
Titolo Testata:
Journal of clinical apheresis
fascicolo: 4, volume: 10, anno: 1995,
pagine: 171 - 177
SICI:
0733-2459(1995)10:4<171:IBAPFT>2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
TUMOR-NECROSIS-FACTOR; SEPTIC SHOCK; INTERLEUKIN-1; SERUM; ASSOCIATION; DISEASE; PURPURA; SEPSIS;
Keywords:
SEPSIS; DISSEMINATED INTRAVASCULAR COAGULATION; APHERESIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
18
Recensione:
Indirizzi per estratti:
Citazione:
K.B. Churchwell et al., "INTENSIVE BLOOD AND PLASMA-EXCHANGE FOR TREATMENT OF COAGULOPATHY IN MENINGOCOCCEMIA", Journal of clinical apheresis, 10(4), 1995, pp. 171-177

Abstract

Eight pediatric patients with fulminant meningococcemia, purpura, anddisseminated intravascular coagulation who by multiple prognostic scoring systems were anticipated to have a poor outcome underwent intensive plasma exchange (IPE) or whole blood exchange (WEE) in addition to standard medical therapy. IPE/WBE was initiated shortly after admission with a mixture of both fresh frozen plasma and cryoprecipitate as the replacement solution. All IPE procedures were performed using a continuous flow system and a red cell prime. The mean fibrinogen level increased from 62 to 192 mg/dl, the prothrombin time (PT) decreased from a mean of 32.4 seconds to 15.1 seconds, and the mean activated partialthromboplastin time (APTT) decreased from 89.5 seconds to 40.1 seconds following completion of the initial IPE/WBE. There was a corresponding improvement in all coagulation factor levels but only slight improvement in antithrombin III (ATIII) and protein C levels. Seven of eightpatients survived (87.5%) their initial presentation with the sole early death attributed to meningitis with cerebral edema. Mean fluid balance after the procedure was +10.8 +/- 5.87 cc/kg. There were no significant bleeding or cardiovascular complications during the procedure. There was no clinical or radiographic evidence of fluid overload afterthe procedure. This experience demonstrates that IPE/WBE may be conducted safely in critically ill, unstable pediatric patients and is effective in rapidly improving coagulopathy without fluid overload. (C) 1995 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/01/20 alle ore 00:41:07