Effect of Therapeutic Plasma Exchange on Outcomes of Patients with Autoimmune Neurological Hospitalised in the ICU of Adam Malik Hospital

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Abstract Title *

Effect of Therapeutic Plasma Exchange on Outcomes of Patients with Autoimmune Neurological Hospitalised in the ICU of Adam Malik Hospital

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Bastian Lubis bastian.lubis@usu.ac.id Universitas Sumatra Utara Anesthesiology & Intensive Care MEDAN Indonesia *

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Introduction

Therapeutic plasma exchange (TPE) can remove circulating pathogenic substances such as autoantibodies from the bloodstream thereby improving clinical outcomes. Diseases such as Myasthenia Gravis and Guillain-Barre Syndrome often cause paralysis that requires intensive care, one of the expected uses of TPE. The purpose of this study was to determine the effect of TPE on the outcome of patients with neurological autoimmunity treated at Adam Malik Hospital Medan.

Methods

Analytical retrospective study was used in patients with neurological autoimmune disorders who performed TPE and were attached to a ventilator at Adam Malik Hospital Medan. Demographic data, clinical outcomes, duration of ventilator use, assessment of changes in neurological autoimmune scores using Myasthenia Composite Scale (MCS) and GuillainBarre Disability Scale (GBDS) before and after TPE (1-2 cycles) were analysed using descriptive and inferential statistical methods.

Results

there ware 22 patients who underwent TPE, 16 people with myasthenia gravis underwent TPE and 9 people with Guillain Barre Syndrome underwent TPE, but no significant difference was found between the two (p>0.05). In contrast, there was a decrease in MCS values after TPE, with a significant difference between the two groups (p<0.05).

Conclusion

TPE was shown to have a positive impact on the outcomes of patients with neurological autoimmunity in the ICU of Adam Malik Hospital Medan. Further research is needed to explore the long-term effects and optimisation of TPE protocols in this population.

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