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Updated: May 19, 2026

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

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Published on: April 7, 2023

Navigating Therapeutic Plasma Exchange in Critically Ill Children: A Retrospective Review of Indications, Timing,

Siddannagoud Salatogi1, Sathwik Gangireddy1, Manas R Sahoo2

  • 1Department of Pediatrics, All-India Institute of Medical Sciences (AIIMS), Raipur, India.

Journal of Clinical Apheresis
|May 18, 2026
PubMed

Insights

Membrane-based therapeutic plasma exchange (mTPE) is a safe option for critically ill children, with over 60% recovering. Early intervention is key, especially for acute liver failure, to improve outcomes in pediatric intensive care units (PICUs).

Area of Science:

  • Pediatric Intensive Care
  • Renal and Hepatic Diseases
  • Apheresis Techniques

Background:

  • Critically ill children often require advanced therapies.
  • Membrane-based therapeutic plasma exchange (mTPE) is an apheresis technique used in intensive care settings.
  • Understanding mTPE's role in pediatric intensive care units (PICUs) is crucial.

Purpose of the Study:

  • To review indications, timing, outcomes, and complications of mTPE in critically ill children.
  • To identify factors influencing mortality in patients undergoing mTPE.
  • To assess the effectiveness of mTPE in a pediatric intensive care unit (PICU) setting.

Main Methods:

  • Retrospective observational study.
  • Analysis of 106 pediatric patients (1 month to 18 years) undergoing mTPE from January 2022 to December 2024.
  • Logistic regression analysis to identify predictors of mortality.

Main Results:

  • Renal and hepatic diseases were the most common indications for mTPE.
  • Overall recovery and discharge rate was 61.3%.
  • Complications occurred in 35.8% of patients.
  • Fluid-refractory shock, high PRISM-3 scores, and concurrent CRRT predicted mortality.
  • For liver disease patients, timely mTPE initiation improved survival.

Conclusions:

  • Membrane-based therapeutic plasma exchange (mTPE) is a safe and feasible adjunctive therapy for critically ill children.
  • Outcomes of mTPE are variable and depend on the underlying condition and intervention timing.
  • Early mTPE is particularly important for acute liver failure in pediatric intensive care.

Keywords:
acute liver failurecomplicationscritical illnesspediatric intensive care unittherapeutic plasma exchange

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