PP311 Topic: AS06–Extracorporeal Organ Support: ECMO/Ventricular Assist Devices (Temporary & Durable)/MARS/Total Plasma Exchange/Plasmapheresis/Other: THERAPEUTIC PLASMA EXCHANGE IN PEDIATRIC INTENSIVE CARE UNIT: A TUNISIAN SINGLE-CENTER EXPERIENCE

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Aims & Objectives: Therapeutic plasma exchange (TPE) is a technique of extracorporeal blood purification used in a wide range of diseases. While there are many studies on TPE in adult patients, few have focused on its use in the pediatric population. Aim: To analyse the clinical indications, outcomes, and complications of TPE in pediatric intensive care unit (PICU). Methods: This is a retrospective study conducted in the PICU of Sahloul hospital. Our study included all patients who underwent TPE and were hospitalized between 2000 and 2023. Results: Eight patients were included in our study. Their mean age was 11 years [5-22 yers old]. The indication of TPE was: atypical hemolytic uremic syndrome (3 cases), Guillain-Barré syndrome (2 cases), transverse myelitis (1 case), neuromyelitis optica (1 case) and purpura thrombotic thrombocytopenic (1 case). The delay between the onset of the disease and the performance of TPE was at an average of 17 days [5–33 days]. Four patients were on vasoactive drugs and 5 patients were on mechanical ventilation at the initiation of TPE. The outcome was favorable in patients with renal diseases, while the 4 patients with neurological pathologies died. These latter patients had more altered PRISM III and PELOD 2 scores compared to survivors. Conclusions: TPE has shown its effectiveness in several severe pediatric diseases. However, it remains a technique associated with high morbi-mortality, especially in patients hospitalized in PICU. Certainly, this high morbi-mortality cannot be solely attributed to TPE but to the critical condition of the patients undergoing this technique. Keywords: Plasma exchange, Children, morbidity

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