DefinePK

Research Objective

To determine the frequency and type of adverse effects associated with plasmapheresis among patients with neurological disorders at a tertiary care hospital in Pakistan.

Methodology

Prospective longitudinal study conducted at Pak Emirates Military Hospital, Rawalpindi, Pakistan, from January to June 2019. The study included 150 patients aged 12-65 years with neurological disorders requiring plasmapheresis. Patients with dementia, delirium, substance use history, non-neurological illnesses, or pregnant women were excluded. Adverse effects were monitored during and up to 48 hours after the procedure. Statistical analysis was performed using SPSS version 24.

Methodology Flowchart

                        graph TD;
    A["Patient Screening & Inclusion"] --> B["Plasmapheresis Procedure"];
    B --> C["Monitor for Adverse Effects"during & 48h post""];
    C --> D["Data Collection on Adverse Effects & Outcomes"];
    D --> E["Statistical Analysis"];
    E --> F["Report Findings"];                    

Discussion

Plasmapheresis is considered a relatively safe procedure for neurological illnesses with an immunological basis. The study found that most adverse effects were minor and resolved within 48 hours, aligning with findings from studies in Western countries. Allergic reactions and abdominal pain were the most frequently reported side effects. The high proportion of male patients in the study is attributed to the military hospital setting. Limitations include not separately analyzing adverse effects by disease, not establishing a link between disease nature and adverse effects, and excluding critically ill patients.

Key Findings

Out of 150 patients, 18 (12%) experienced one or more adverse effects, while 132 (88%) did not. The mean age of patients was 30.2 ± 2.698 years. Guillain-Barré syndrome was the most common disorder (40.6%) for which plasmapheresis was performed. Allergic reactions (2.6%) were the most common adverse effect, followed by abdominal pain (2%). 146 (97.4%) patients were shifted to the ward, and 4 (2.6%) required ICU admission due to complications. No mortality was reported due to the procedure.

Conclusion

Plasmapheresis is a relatively safe procedure for neurological illnesses with an immunological basis. Patients and physicians should be informed about potential adverse effects, particularly allergic reactions and abdominal pain.

Fact Check

- 12% of patients (18 out of 150) developed one or more adverse effects.
- Guillain-Barré syndrome was the most common condition (40.6%) for which plasmapheresis was performed.
- 97.4% of patients (146 out of 150) were shifted to the ward after the procedure without significant events.

Mind Map