OP-082 Plasma exchange impact on cytokines

• Published in: BMJ paediatrics open 2024-07, Vol.8 (Suppl 5), p.A38-A39
• Main Authors: Cakmak, Selen Ceren, Tugrul, Hazal Ceren, Unlu, Dilan Akgun, Atay, Gurkan, Erdogan, Seher, Sozeri, Betul
• Format: Article
• Language: English
• Subjects: Apheresis; Blood pressure; IL-6; Medical prognosis; Oral Presentation; Pediatric Intensive Care Unit; Pediatrics; Therapeutic Plasma Exchange; TWEAK; Ventilators
• ISSN: 2399-9772
• DOI: 10.1136/bmjpo-2024-EPAC.81

AimTherapeutic plasma exchange (TPE) is a life-saving method when performed for appropriate indications. The aim of this study was to investigate the effect of therapeutic plasma exchange on tumor necrosis factor-like weak inducer of apoptosis (TWEAK) protein and interleukin-6 (IL-6) levels in critically ill pediatric patients who underwent TPE for various reasons.Material and MethodThe study was conducted on patients who underwent TPE in the pediatric intensive care unit between May and December 2022. Demographic characteristics, laboratory parameters, TWEAK, and IL-6 levels before and after the procedure were recorded (table 1).ResultsThe study involved 41 patients, with 53.7% males, 51.2% having underlying diseases, 39% showing sepsis symptoms, and 36.6% receiving ventilation support. The survival rate was 68.3%. IL-6 levels significantly increased after TPE (p: 0.006), while TWEAK levels significantly decreased (p: 0.030). Positive correlations were found between IL-6 levels before TPE and ventilation days, and ferritin levels. TWEAK levels before TPE correlated with organ failures, OFI, and D-Dimer levels. No significant difference in IL-6 and TWEAK levels was observed based on prognosis (p > 0.05).Abstract OP-082 Table 1Demographic characteristics of patients Minimum Maximum Mean±Standard Deviation Median Age (month) 2 191 91,07±67,74 72 Weight (kg) 5 90 28,46±20,09 20 Hearth Rate/minute 50 180 111,41±34,33 115 Systolic Blood Pressure (mmHg) 40 149 98,85±23,72 100 Diastolic Blood Pressure (mmHg) 20 96 61,83±17,96 60 Respiratory rate/minute 14 42 28,17±6,95 30 Days of PICU hospitalization 3 170 25,68±29,79 13 Gender n (%) Male 22 %53,7 Female 19 %46,3 ConclusionsIn our study, we compared IL-6 and TWEAK levels in survivors and deceased patients before and after TPE, finding no significant difference. Deceased patients had higher organ failure and severity scores. Post-TPE, deceased patients showed elevated ALT, AST, PCT, and INR levels, and lower platelet counts. Higher baseline TWEAK correlated with more organ failures and D-dimer levels. TWEAK levels significantly decreased post-TPE, while IL-6 levels did not. Elevated TWEAK was associated with more severe outcomes, and IL-6 with longer ventilation and higher ferritin. Both markers may indicate disease severity but might not be sufficient for prognosis prediction.