prikaz prve stranice dokumenta Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department
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master's thesis
Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department
Split: University of Split, School of Medicine, 2024. urn:nbn:hr:171:975748
Niederecker, Konstantin
University of Split
School of Medicine

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Niederecker, K. (2024). Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department (Master's thesis). Split: University of Split, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:171:975748

Niederecker, Konstantin. "Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department." Master's thesis, University of Split, School of Medicine, 2024. https://urn.nsk.hr/urn:nbn:hr:171:975748

Niederecker, Konstantin. "Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department." Master's thesis, University of Split, School of Medicine, 2024. https://urn.nsk.hr/urn:nbn:hr:171:975748

Niederecker, K. (2024). 'Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department', Master's thesis, University of Split, School of Medicine, accessed 29 November 2024, https://urn.nsk.hr/urn:nbn:hr:171:975748

Niederecker K. Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department [Master's thesis]. Split: University of Split, School of Medicine; 2024 [cited 2024 November 29] Available at: https://urn.nsk.hr/urn:nbn:hr:171:975748

K. Niederecker, "Clinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department", Master's thesis, University of Split, School of Medicine, Split, 2024. Available at: https://urn.nsk.hr/urn:nbn:hr:171:975748

Metadata
TitleClinical features and outcomes of patients treated with therapeutic plasma exchange in intensive care unit of the internal medicine department
Title (croatian)Kliničke osobitosti i ishodi liječenja bolesnika liječenih terapijskom izmjenom plazme u internističkoj intenzivnoj jedinici
AuthorKonstantin Niederecker
MentorTanja Ilić Begović (mentor)
Committee memberZenon Pogorelić (predsjednik povjerenstva)
Committee memberTonći Brković (član povjerenstva)
Committee memberDejana Bogdanić (član povjerenstva)
GranterUniversity of Split
School of Medicine
Split
Defense date and country2024-07-17, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Abstract
Objectives: The objective of study was to assess the clinical characteristics, laboratory parameters and specific apheresis parameters of patients treated with therapeutic plasma exchange (TPE) in the internal intensive care unit (ICU). Subjects and Methods: An observational retrospective study was conducted during ten-year period. Subjects were patients treated with TPE in ICU of the Internal medicine department Results: In total 48 patients were treated in ICU with TPE with median age of 51.12 years and 29 (60.4%) of them were women. Most common indications for TPE were Thrombotic thrombocytopenic purpura (TTP) in 31 (64,58%) patients, followed by 5 (10.42%) patients with hyperviscosity syndrome, 5 (10.42%) patients with systemic vasculitis and 5 (10.42%) patients had severe hypertriglyceridemia. Symptomatology included malaise and weakness in 17 (26.56%) patients, followed by 14 (21.88%) patients with neurological symptoms, 8 (12,5%) patients with jaundice and 6 (9,38%) patients had bleeding into skin. Gender differences revealed that females had higher levels of serum albumin (39.17±7.29 vs. 34.26±5.58, p=0.049), while male showed higher levels of urea (31.13±26.98 vs. 9.49±3.31, p=0.001), creatinine (409.89±392.20 vs. 80.45±32.35, p<0.001), and procalcitonin (2.78±2.54 vs. 0.29±0.27, p=0.013). A total of 6 (12.5%) patients ceased and all were diagnosed with TTP. Patients who survived had longer hospital stay (25.78±15.75 days vs. 9.33±6.86, p=0.010), higher number of TPE treatments (10.29±7.04 vs. 3.50±2.59, p=0.014), and higher amount of total TPE used plasma (42244.36±33490.24 vs. 12238.33±8518.37, p=0.021). The ceased patients had significantly higher levels of leucocytes (12.23±3.98 vs. 10.30±4.81, p=0.033) and creatinine (270.60±250.85 vs. 164.38±265.86, p=0.001). Length of hospital stay correlated positively with number of TPE treatments (p=0.004) and total TPE plasma volume (p=0.004). Patients with initially higher levels of troponin had been treated with higher total TPE plasma volume. Conclusion: Most common indication for TPE in internal ICU was TTP with higher prevalence in female patients. All ceased patients were diagnosed with TTP. Initially higher levels of troponin were associated with use of higher plasma volumes in TPE treatments.
Abstract (croatian)
Cilj istraživanja: Cilj ovog istraživanja je bio procijeniti kliničke karakteristike, laboratorijske pokazatelje i parametre postupka afereze kod bolesnika liječenih terapijskom izmjenom plazme (TIP) u internističkom JIL-u (Jedinici intenzivnog liječenja). Ispitanici i metode: Opservacijska retrospektivna studija provedena je tijekom desetogodišnjeg razdoblja. Ispitanici su bili odrasli bolesnici liječeni s TIP-om u internističkom JIL-u. Rezultati: Ukupno 48 bolesnika je liječeno u internističkom JIL-u sa TIP-om prosječne dobi 51.12 godina od čega je bilo 29 (60.4%) žena. Najčešće indikacije za liječenje TIP-om bile su TTP kod 31 (64,58%) bolesnika, 5 (10.42%) bolesnika je imalo hiperviskozni sindrom, 5 (10.42%) sistemski vaskulitis i 5 (10.42%) tešku hipertrigliceridemiju. Najviše se bolesnika prezentiralo slabošću i malaksalošću, njih 17 (26.56%), potom slijedi 14 (21.88%) bolesnika sa neurološkim simptomima, 8 (12,5%) sa žuticom i 6 (9,38%) sa krvarenjem u kožu. Žene su imale više razine serumskog albumina (39.17±7.29 vs. 34.26±5.58, p=0.049), dok su muškarci imali značajno više vrijednosti ureje (31.13±26.98 vs. 9.49±3.31, p=0.001), kreatinina (409.89±392.20 vs. 80.45±32.35, p<0.001) i prokalcitonina (2.78±2.54 vs. 0.29±0.27, p=0.013). Ukupno 6 (12.5%) bolesnika je preminulo i svi su pripadali skupini bolesnika s TTPom. Bolesnici koji su preživjeli su imali značajno duže vrijeme boravka u bolnici (25.78±15.75 dana vs. 9.33±6.86, p=0.010), veći broj TIP postupaka (10.29±7.04 vs. 3.50±2.59, p=0.014. ) i veću količinu plazme korištene u TIP postupcima (42244.36±33490.24 vs. 12238.33±8518.37, p=0.021.). Preminuli bolesnici su imali značajno povišene vrijednosti leukocita (12.23±3.98 vs. 10.30±4.81, p=0.033.) i kreatinina (270.60±250.85 vs. 164.38±265.86, p=0.001.). Duljina boravka u bolnici je pozitivno korelirala sa brojem postupaka TIP (p=0.004) i ukupnim volumenom izmijenjene plazme (p=0.004). Bolesnici sa višim početnim vrijednostima troponina su liječeni sa ukupno većom količinom plazme. Zaključak: Najčešća indikacija za liječenje terapijskom izmjenom plazme u internističkom JIL-u je TTP sa značajno višom prevalencijom kod žena. Svi umrli bolesnici su imali dijagnozu TTP-a. Vrijednosti troponina su bile povezane sa dozom ukupnog volumena plazme korištenog u postupcima TIP-a.
Keywords
Keywords (croatian)
Languageenglish
URN:NBNurn:nbn:hr:171:975748
Study programmeTitle: Medical Studies in English
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Embargo expiration date: 2024-07-17
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Created on2024-07-16 12:32:14