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Therapeutic Plasma Exchange in Pediatric Intensive Care and Brief Overview of the Literature

Abdulrahman Ozel1, Ulkem Kocoglu Barlas2, Servet Yuce3

  • 1Department of Pediatrics, Health Sciences University Türkiye, Bagcilar Training and Research Hospital, Pediatric Intensive Care Unit, Istanbul, Türkiye.

Sisli Etfal Hastanesi Tip Bulteni
|January 23, 2026
PubMed

Insights

Therapeutic plasma exchange (TPE) is a safe and effective treatment in the pediatric intensive care unit (PICU), with hypotension being the most common complication. Sepsis is the leading indication for TPE in this population.

Area of Science:

  • Pediatric Critical Care Medicine
  • Hematology
  • Nephrology

Background:

  • Therapeutic plasma exchange (TPE) is an extracorporeal procedure used to remove harmful substances from the plasma.
  • Its application in pediatric intensive care units (PICUs) requires careful evaluation of indications, outcomes, and complications.

Purpose of the Study:

  • To evaluate the therapeutic plasma exchange (TPE) procedures performed in a pediatric intensive care unit (PICU).
  • To review the relevant literature on TPE in critically ill children.
  • To assess the safety and efficacy of TPE in a pediatric population.

Main Methods:

  • Retrospective study conducted between 2020 and 2024.
  • Inclusion of 49 patients who received TPE during their PICU stay.
  • Categorization of patients into survivor and non-survivor groups for comparative analysis.

Main Results:

  • Sepsis, trauma-induced multiple organ dysfunction syndrome/disseminated intravascular coagulation, and neurological diseases were the most common indications for TPE.
  • Non-survivors exhibited higher rates of chronic illness, increased pediatric risk of mortality scores, and greater use of invasive mechanical ventilation and continuous renal replacement therapy.
  • Hypotension was the most frequent complication (9.9%), with no life-threatening adverse events reported.

Conclusions:

  • Sepsis is the predominant indication for TPE in the PICU setting.
  • TPE is a safe treatment modality in critically ill children, with manageable complications such as hypotension.
  • The study supports the continued use of TPE for specific indications in pediatric critical care.
Abstract

Keywords:
Critical careencephalitismultiple organ failuremultiple traumasepsis

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