Merve KARA YAZICI, KEZİBAN SANEM ÇAKAR TURHAN, Ali Abbas YILMAZ, Mehmet ORAL

Yoğun bakım ünitesinde HELLP Sendromu ve eklampsi hastalarına uygulanan plazmaferez tedavisinin etkinliği

Amaç: Çalışmamızda yoğun bakım ünitemizde HELLP Sendromu ve eklampsi tanılarıyla izlenen hastalara uygulanan plazmaferez tedavisinin etkinliği ortaya konulmuş- tur. Yöntemler: 2005-2010 yılları arasında yoğun bakım ünitemizde izlenen ve plazmaferez uygulanan HELLP Sendromu ve eklampsi hastalarının tedavi öncesi demografik özellikleri, plazmaferez öncesi ve sonrası fizik muayene bulguları, biyokimyasal parametreleri, hematolojik bulguları, arter kan gazı değerleri, idrar çıkışları APACHE II (Acute Physiology and Chronic Health Evaluation System), GKS, (Glasgow Koma Skorlaması), SOFA (Sequential Organ Failure Assessment) ve MODS skorlaması (Multiple Organ Dysfunction Score) kaydedildi. Yapılan plazmaferez tedavisi sonrası işlemin etkinliği değerlendirildi. Bulgular: 16 hastanın 8i HELLP Sendromu, 6sı eklampsi tanılarıyla takip edildi. Hastaların yaş ortalaması 29,5(±5,9) idi. Eklampsi tanısıyla takip edilen 6 hastadan 2si, HELLP Sendromu tanısı ile takip edilen 8 hastadan 1i yaşamını yitirmiştir. Yaş, yoğun bakıma alındığı andaki APACHE II, MODS, GKS ve hastanın mevcut idrar miktarı mortaliteyi belirleyen parametrelerdir (p

The effectiveness of plasmapheresis treatment in the patients with HELLP Syndrome and eclampsia in the intensive care unit

Objective: In our study we aimed to state the effectiveness of plasmapheresis treatment in the patients with HELLP Syndrome and eclampsia in the intensive care unit. Methods: Patients who are with the diagnosis of HELLP Syndrome and eclampsia in our intensive care unit between the years of 2005-2010 were reviewed retrospectively. The patients characteristics, before and postplasmapheresis biochemical and hematological values, urine outputs, APACHE II (Acute Physiology and Chronic Health Evaluation System), GCS, (Glasgow Coma Scoring), SOFA (Sequential Organ Failure Assessment) and MODS Scoring (Multiple Organ Dysfunction Score) are recorded. The effectiveness of plasmapheresis is evaluated. Results: 8 were HELLP Syndrome and 6 were eclampsia of 16 patients. The mean age was 29,5(±5,9). 2 of 6 eclampsia patients and, 1of 8 HELLP Syndrome patient were died. Age, APACHE II, MODS, GCS and the urine output are the significant clinical factors that determines the mortality (p<0.03). After the plasmapheresis therapy a significant improvement was seen in platelet and total protein numbers, MODS score, AST, GGT, LDH, lactate and creatinine levels. (p<0.03) Conclusion: Plasmapheresis treatment in the patients with HELLP Syndrome and eclampsia is a safe method and provides a significant development in biochemical values and patients clinics.

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