Evaluation of the effect of therapeutic plasma exchange on serum cytokine levels in pediatric intensive care unit

Introduction: Therapeutic plasma exchange (TPE) is crucial for saving lives when used appropriately. This study aimed to assess TPE's impact on tumor necrosis factor-like weak inducer of apoptosis (TWEAK) protein and IL-6 levels in critically ill pediatric patients.

Methods: Conducted between May 2022 and December 2022, the study observed pediatric intensive care unit (PICU) patients undergoing TPE, recording demographics, lab results, TWEAK, and IL-6 levels pre- and post-procedure.

Results: Of 41 patients, 53.7% were male, 51.2% had underlying conditions, and 39% showed sepsis symptoms. IL-6 levels significantly rose post-TPE (p: 0.006), while TWEAK protein levels dropped (p: 0.030). Positive correlations were found between interleukin-6 (IL-6) pre-TPE and ventilation duration, ferritin levels (p <0.05), and TWEAK pre-TPE and organ failure indicators, D-Dimer levels (p <0.05). Prognosis showed no significant difference in IL-6/TWEAK levels (p >0.05).

Conclusion: Serum IL-6 and TWEAK can indicate disease severity and inflammation level, but may not predict prognosis accurately.

Clinical trial registration: Our study has clinical study registration number B.10.1.TKH.4.34.H.GP.0.01/154 of the University of Health Sciences Ümraniye Training and Research Hospital.