title: Effectiveness of therapeutic plasma exchange in patients with intermediate syndrome due to organophosphate intoxication.
abstract: OBJECTIVE
  We aimed to determine effectiveness of therapeutic plasma exchange (TPE) in patients with intermediate syndrome (IMS) due to organophosphate (OP) intoxication.
  
  
  METHODS
  Patients diagnosed with IMS due to OP intoxication were included in this prospective study. Therapeutic plasma exchange procedure was performed with fresh frozen plasma as a replacement fluid via Fresenius-AS-TEC 204 device by Therapeutic Apheresis Unit to patients who developed IMS during follow-up. Samples were taken from patient's blood and waste plasma collected in the device before and after TPE procedure to be studied in laboratory for detection of organic phosphate and pseudocholinesterase (PChE) levels. In this study, SPSS 18.0 software package was used for statistical analysis of the data obtained. Level of statistical significance was taken as P < .05 for all tests.
  
  
  RESULTS
  Of all 17 patients, 4 (23.5%) were female, and 13 (76.5%) were male. A statistically significant decrease was detected in organic phosphate levels in the plasma of patients after TPE procedure (P = .012). A statistically significant increase was detected in PChE levels in the plasma of patients after TPE procedure (P = .014). Of 17 patients included in the study, 13 patients showed clinical improvement and were discharged after the TPE process.
  
  
  CONCLUSIONS
  In our study, it was observed that a significant decrease in the level of blood plasma OP and a significant increase in the level of PChE were achieved with TPE process in the early period of IMS due to OP poisoning. This study indicates that TPE is one of the effective treatment options for IMS due to OP intoxication.
authors.affiliation: Necip Fazil State Hospital, Emergency Medicine Service, Kahramanmaras, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sebe
authors.forename: Mehmet Oguzhan
authors.initials: MO
authors.lastname: Ay
authors.forename: Umut
authors.initials: U
authors.lastname: Gumusay
authors.forename: Metin
authors.initials: M
authors.lastname: Topal
authors.forename: Mesude
authors.initials: M
authors.lastname: Atli
authors.forename: Ferhat
authors.initials: F
authors.lastname: Icme
authors.forename: Salim
authors.initials: S
authors.lastname: Satar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002091:Butyrylcholinesterase / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning / Q000628:therapy*; D010951:Plasma Exchange; D013577:Syndrome; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002091:Butyrylcholinesterase