title: Plasmapheresis in Pediatric Intensive Care Unit.
abstract: BACKGROUND
  Plasmapheresis also known as a therapeutic plasma exchange (TPE) is extracorporeal procedure by which individual components of plasma that are harmful or blood cells can be removed from organism by using a blood separation technology.
  
  
  OBJECTIVE
  To present the results of the implementation of plasmapheresis in children in the Department of Pediatric Intensive Care of Pediatric Clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina.
  
  
  METHODS
  Research (period from December 2011 to June 2016) analyzed 66 plasmapheresis (11 patients-6 plasmapheresis per patient).
  
  
  RESULTS
  Out of 11 patients, 7 (63.6%) were girls and 4 (36.4%) were boys. The average age of patients was 11.6 ± 3.9 years (the youngest patient had 4 years and 7 months, while the oldest had 16 years and 10 months). Plasmapheresis were significantly more often done in the winter and summer. Underlying disease was in 54.5% of cases of neurological origin. The treatment was in form of receiving IVIG in 7 patients, or the application of mechanical ventilation in 6 patients. The most common complication was hypotension, which occurred in 45.5% of patients, followed by bleeding in 36.3%, hypercoagulability in 27.2% of patients and hematoma in 27.2% of patients. Lethal outcome occurred in 3 (27.2%) patients.
  
  
  CONCLUSIONS
  Plasmapheresis represents an invasive method due to need for placement of centralized venous catheter that provides adequate blood flow during the procedure. Although complications can be serious, they are rare and are mainly related to the presence of central venous catheter, hemostasis disorders due to use of anticoagulant therapy, and hypotension of the cardiovascular system. It should be noted that for success of plasmapheresis in children multidisciplinary approach is necessary (children's nephrologist, neuropediatrician, intensive care doctor) as well as well-trained team of doctors and nurses with the acquired knowledge and skills.
authors.affiliation: Pediatric Clinic, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Verica
authors.initials: V
authors.lastname: Misanovic
authors.affiliation: Pediatric Clinic, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Danka
authors.initials: D
authors.lastname: Pokrajac
authors.affiliation: Pediatric Clinic, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Smail
authors.initials: S
authors.lastname: Zubcevic
authors.affiliation: Pediatric Clinic, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Admir
authors.initials: A
authors.lastname: Hadzimuratovic
authors.affiliation: Pediatric Clinic, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Samra
authors.initials: S
authors.lastname: Rahmanovic
authors.affiliation: Pediatric Clinic, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Selma
authors.initials: S
authors.lastname: Dizdar
authors.affiliation: Clinic for Pediatric Surgery, University Clinical Center Sarajevo, Bosnia and Herzegovina.
authors.forename: Asmir
authors.initials: A
authors.lastname: Jonuzi
authors.affiliation: Health Center Maglaj, Maglaj, Bosnia and Herzegovina.
authors.forename: Edin
authors.initials: E
authors.lastname: Begic
mesh_terms: D000293:Adolescent; D017522:Bosnia and Herzegovina; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D018579:Patient Selection; D010956:Plasmapheresis; D012189:Retrospective Studies
keywords: complications; indications; plasmapheresis