The role of therapeutic plasma exchange in the treatment of patients with septic shock- single center experience

Aims: Sepsis is a life-threatening organ dysfunction resulting from an excessive inflammatory response in the host due to infection. Due to the activation of the coagulation system in sepsis, the search for treatment has shifted in this direction and therapeutic plasma exchange (TPE). This study, it was aimed to compare the hemogram and biochemical values and inflammatory markers of patients who underwent TPE before and after TPE. Methods: The research data were obtained retrospectively from the records on the hospital system of the patients who were hospitalized in Malatya İnönü University Faculty of Medicine Intensive Care Clinic and were treated with TPE. Results: A total of 25 patients were included. It was observed that platelet count (p=0.427), hemoglobulin (p=0.545), leukocyte (p=0.527) and neutrophil (p=0.657) counts decreased statistically after TPE. It was observed that C-reactive protein (p=0.065) and procalcitonin (p=0.267) values also decreased after TPE procedure. Among the direct bilirubin (p=0.326), total bilirubin (p=0.397), AST (p=0.840) and alanine transferase(ALT) (p=0.122) values, it was determined that the aspartate transferase (AST) value increased after the TPE procedure and the others decreased. It was observed that the blood urea nitrogen (p=0.326) value increased after TPE procedure, while creatinine (p=0.677) value decreased. Conclusion: TPE process can reduce harmful components in plasma. Since it is of vital importance to reduce harmful components in the plasma in sepsis, TPE can be applied by evaluating patient-specifically. Our study is important in terms of showing that TPE can be an alternative treatment modality in patients with sepsis and septic shock.