Research priorities for therapeutic plasma exchange in critically ill patients

Intensive Care Medicine Experimental

Reviews

Anne C. Brignier¹  Joan Cid²  Matthias Kochanek³  Luca Montini⁴  Ignacio Martin-Loeches⁵  Lene Russell⁶  Marlies Ostermann⁷  Nicole P. Juffermans⁸  Bruno L. Ferreyro⁹  Nathan D. Nielsen^1,10  Chiara Robba^1,11  Sascha David^1,12  Tasneem Pirani^1,13  Jan T. Kielstein^1,14  Pedro Castro^1,15  Andry van de Louw^1,16  Lara Zafrani^1,17  Eric Mariotte^1,17 

[1] Apheresis Unit, Saint-Louis Hospital, AP-HP, University of Paris Cite, Paris, France;Apheresis and Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Clínic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain;Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO), University of Cologne, Cologne, Germany;Department of Intensive Care Medicine and Anesthesiology, “Fondazione Policlinico Universitario Agostino Gemelli IRCCS” Università Cattolica del Sacro Cuore, Rome, Italy;Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James’s Hospital, D08 NHY1, Dublin, Ireland;Department of Clinical Medicine, School of Medicine, Trinity College Dublin, D02 PN91, Dublin, Ireland;Institut D’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Universidad de Barcelona, Ciberes, Barcelona, Spain;Department of Intensive Care, Copenhagen University Hospital Gentofte, Copenhagen, Denmark;Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Department of Intensive Care, Guy’s & St Thomas’ Hospital, King’s College London, London, UK;Department of Intensive Care, OLVG Hospital, Amsterdam, The Netherlands;Laboratory of Translational Intensive Care, Erasmus MC, Rotterdam, The Netherlands;Department of Medicine, Sinai Health System and University Health Network, Toronto, Canada;Division of Pulmonary, Critical Care and Sleep Medicine & Section of Transfusion Medicine and Therapeutic Pathology, University of New Mexico School of Medicine, Albuquerque, USA;IRCCS per Oncologia e Neuroscienze, Genoa, Italy;Dipartimento di Scienze Chirurgiche Diagnostiche ed Integrate, Universita’ di Genova, Genoa, Italy;Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland;Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany;King’s College Hospital, General and Liver Intensive Care, London, UK;Medical Clinic V, Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital Braunschweig, Brunswick, Germany;Medical Intensive Care Unit, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain;Medical Intensive Care Unit, Penn State Health Hershey Medical Center, Hershey, PA, USA;Medical Intensive Care Unit, Saint-Louis Hospital, AP-HP, University of Paris Cité, Paris, France;

关键词: Knowledge;    Gaps;    Plasmapheresis;    Expert panel;    Apheresis;    Research;    Plasma exchange;    Research;   

DOI  :  10.1186/s40635-023-00510-w

 received in 2023-01-23, accepted in 2023-04-10,  发布年份 2023

来源: Springer

【 摘 要 】

Therapeutic plasma exchange (TPE) is a therapeutic intervention that separates plasma from blood cells to remove pathological factors or to replenish deficient factors. The use of TPE is increasing over the last decades. However, despite a good theoretical rationale and biological plausibility for TPE as a therapy for numerous diseases or syndromes associated with critical illness, TPE in the intensive care unit (ICU) setting has not been studied extensively. A group of eighteen experts around the globe from different clinical backgrounds used a modified Delphi method to phrase key research questions related to “TPE in the critically ill patient”. These questions focused on: (1) the pathophysiological role of the removal and replacement process, (2) optimal timing of treatment, (3) dosing and treatment regimes, (4) risk–benefit assumptions and (5) novel indications in need of exploration. For all five topics, the current understanding as well as gaps in knowledge and future directions were assessed. The content should stimulate future research in the field and novel clinical applications.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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Fig. 2