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Therapeutic plasma exchange and cytapheresis in pediatric patients
1Memorial Blood Centers of Minnesota, University of Minnesota, Minneapolis 55404, USA. jed@mbcm.org
Insights
Pediatric therapeutic apheresis involves specialized procedures like erythrocytapheresis and plasma exchange for children. This review highlights unique patient needs and common apheresis applications in pediatrics.
Area of Science:
- Pediatric Nephrology
- Hematology
- Critical Care Medicine
Background:
- Pediatric patients have unique physiological considerations.
- Therapeutic apheresis requires specialized protocols in children.
- Careful management of fluid balance, anticoagulation, and temperature is crucial.
Purpose of the Study:
- To review pediatric therapeutic apheresis.
- To outline its performance and indications.
- To emphasize special considerations for pediatric patients.
Main Methods:
- Review of common apheresis procedures in pediatrics.
- Discussion of indications and evidence.
- Focus on erythrocytapheresis, leukaphereses, and plasma exchange.
Main Results:
- Commonly performed procedures include erythrocytapheresis, leukaphereses, and plasma exchange.
- A table summarizes the evidence supporting various apheresis indications.
- Unique pediatric needs in fluid replacement, access, anticoagulation, volume shifts, and hypothermia are detailed.
Conclusions:
- Pediatric therapeutic apheresis is a vital treatment modality.
- Understanding and addressing unique pediatric needs is essential for safe and effective application.
- Evidence supports the use of apheresis for various pediatric conditions.
Abstract:
Pediatric therapeutic apheresis is reviewed including what it is, how it is performed and indications for its use. Pediatric patients are special, and the unique needs for replacement fluids and attention to access, anticoagulation, volume shifts and hypothermia are stressed. While all indications cannot be addressed, the procedures most commonly performed are reviewed. These include erythrocytapheresis, leukaphereses and plasma exchanges. A table details the strength of evidence supporting the use of apheresis procedures for many of these indications.