@article{ref1,
title="Assessing the clinical efficacy of low-volume therapeutic plasma exchange in achieving recovery from acute liver failure induced by yellow phosphorous poisoning",
journal="Journal of clinical apheresis",
year="2024",
author="Ninan, Ancy and Mohan, Ganesh and Shanbhag, Vishal and Chenna, Deepika and Shastry, Shamee and Rao, Shwethapriya",
volume="39",
number="3",
pages="e22110-e22110",
abstract="BACKGROUND: Acute liver failure (ALF) following yellow phosphorous (YP) ingestion is similar to acetaminophen-induced ALF and it has become a public concern in our region. This study assessed low volume therapeutic plasma exchange (LV-TPE) efficacy in improving the transplant free survival in YP poisoning. <br><br>METHODS: Adult patients with toxicology reports of YP and ALF requiring critical care were included in the study. LV-TPE was planned for three consecutive days and three more if required. Performed 1.3 to 1.5 plasma volume replacing with 0.9% normal saline, 5% human albumin solution, and fresh frozen plasma based on ASFA 2019 criteria. MELD score, laboratory parameters, LV-TPE details were captured. The study end point was clinical outcome of the patients. <br><br>RESULTS: Among 36 patients, 19 underwent LV-TPE and 17 opted out of LV-TPE and they were included as a control arm. The MELD score was 32.64 ± 8.05 and 37.83 ± 9.37 in both groups. There were 13 survivors in LV-TPE group leading to a 68.42% reduction in mortality. The coagulation and biochemical parameters showed a significant percentage change after LV-TPE. Refractory shock, delay in initiating procedure and acidosis were independent predictors of mortality. <br><br>CONCLUSION: A well-timed LV-TPE improves the survival of patients with ALF due to YP poisoning.<p /> <p>Language: en</p>",
language="en",
issn="0733-2459",
doi="10.1002/jca.22110",
url="http://dx.doi.org/10.1002/jca.22110"
}