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Influence of therap...
Influence of therapeutic plasma exchange treatment on short-term mortality of critically ill adult patients with sepsis-induced organ dysfunction : a systematic review and meta-analysis
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- Kuklin, Vladimir (författare)
- Department of Anaesthesiology and Intensive Care Medicine, Ahus University Hospital, Sykehusveien, 25, Lorenskog, Norway
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- Sovershaev, Michael (författare)
- Fürst Medical Laboratory, Oslo, Norway
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- Bjerner, Johan (författare)
- Fürst Medical Laboratory, Oslo, Norway
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- Keith, Philip (författare)
- Critical Care Medicine, Lexington Medical Center, SC, West Columbia, United States
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- Scott, L. Keith (författare)
- Division of Trauma and Surgical Critical Care, Louisiana State University Health Sciences Center, Shreveport, United States
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- Thomas, Owen Matthew Truscott (författare)
- Department of Health Services Research, Ahus University Hospital, Lorenskog, Norway
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- Szpirt, Wladimir (författare)
- Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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- Rock, Gail (författare)
- University of Ottawa, ON, Ottawa, Canada
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- Stegmayr, Bernd, 1949- (författare)
- Umeå universitet,Institutionen för folkhälsa och klinisk medicin
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(creator_code:org_t)
- BioMed Central (BMC), 2024
- 2024
- Engelska.
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Ingår i: Critical Care. - : BioMed Central (BMC). - 1364-8535 .- 1466-609X. ; 28:1
- Relaterad länk:
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https://doi.org/10.1...
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https://umu.diva-por... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Introduction: The impact of therapeutic plasma exchange (TPE) on short-term mortality in adult patients with sepsis-induced organ dysfunction remains uncertain. The objective of the study is to assess the effect of adjunct TPE in this setting through a comprehensive literature review.Methods: The National Library of Medicine’s Medline, Ovid (Embase), the Cochrane Library database and clinicaltrial.gov from January 01, 1966, until October 01, 2022, were searched for terms: therapeutic plasma exchange, plasmapheresis, sepsis, and septic shock. We reviewed, selected and extracted data from relevant randomized clinical trials (RCTs) and matched cohort studies (MCSs) comparing short-term mortality in critically ill adult septic patients treated with standard therapy versus those receiving adjunct TPE. Risk of bias was assessed in the RCTs using Cochrane Collaboration tool and in MCSs using ROBINS-I tool. Summary statistics, risk ratios (RRs), and confidence intervals (CIs) were calculated using random effects model.Results: This systematic review included 937 adult critically ill septic patients from five RCTs (n = 367) and fifteen MCSs (n = 570). Of these total, 543 received treatment with TPE in addition to standard care. The meta-analysis includes all five RCTs and only six MCSs (n = 627). The adjunct TPE treatment (n = 300) showed a significant reduction in short-term mortality (RR 0.59, 95% CI 0.47–0.74, I2 3%) compared to standard therapy alone (n = 327). The systematic review of all 20 trials revealed that adding TPE to the standard therapy of critically ill septic patients resulted in faster clinical and/or laboratory recovery.Conclusions: Our comprehensive and up-to-date review demonstrates that adjunct TPE may provide potential survival benefits when compared to standard care for critically ill adult patients with sepsis-induced organ dysfunction. While results of this meta-analysis are encouraging, large well-designed randomized trials are required to identify the optimal patient population and TPE procedure characteristics prior to widespread adoption into practice.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
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- Av författaren/redakt...
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Kuklin, Vladimir
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Sovershaev, Mich ...
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Bjerner, Johan
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Keith, Philip
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Scott, L. Keith
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Thomas, Owen Mat ...
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visa fler...
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Szpirt, Wladimir
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Rock, Gail
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Stegmayr, Bernd, ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Anestesi och int ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Allmänmedicin
- Artiklar i publikationen
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Critical Care
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Umeå universitet