Evidence map›Paper›PMID 33681775›Full record

ArticleBMJ neurology open2020

Therapeutic plasma exchange (TPE) for semi-critical neurology presentations in a non-acute neurology set-up: clinical practice and challenges.

Keng Seng Fu, Pei Yin Wong, Fu Liong Hiew

Abstract read
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Article in BMJ neurology open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Keng Seng FuDepartment of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
Pei Yin WongDepartment of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
Fu Liong HiewDepartment of Neurology, Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia.ORCID 0000-0002-4708-3734

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTherapeutic plasma exchange (TPE) for semi-critical neurological manifestations can be managed in non-acute setting instead of critical care unit. In 2014, we established a non-acute neurology TPE unit for semi-critical haemodynamically stable patients. In this study, we aimed to evaluate the technical and safety parameters from the first 3 years of service. MATERIALS AND

methodsWe analysed prospectively collected TPE data for patients treated with centrifugation TPE at our non-acute neurology TPE unit in Kuala Lumpur Hospital between May 2015 and June 2018.

resultsA total of 245 TPE procedures were performed in 55 patients for nine neurological indications, predominantly the central nervous system (79%). Twenty four per cent (n=13) had category I and 73% (n=40) had category II indication (American Society for Apheresis (ASFA) 2019). Others (4%) were not in ASFA indications. Neuromyelitis optica spectrum disorders accounted for half (51%) of the total patients. Twenty-three (41.8%) patients experienced adverse events, with hypotensive episodes being the the most common (n=12/55, 21.8%). Five (9.1%) patients had catheter-related blood stream infection, correlating with higher exchange plasma volume (p=0.023). Symptomatic hypocalcaemia was less common (n=5/55, 9.1%) and allergic reaction to human albumin was rare (n=1/55, 1.8%). Four technical errors detected. Three involved centrifugation sets manufacturing defects and one involved error in centrifugation set installation. Seven (2.9%) procedures were terminated: 5 for adverse effects and 2 for technical errors.

conclusionPerforming TPE among semi-critical patients with neurology manifestations in basic non-acute set-up proved safe, with predictable complications. This set-up reduced the reliance on critical care services for TPE procedures.

Indexed as

Guillain-Barre syndromemultiple sclerosismyasthenianeuropathyNMDA

Identifiers

PMID33681775
PMCPMC7871719

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