{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:45:27Z","timestamp":1792608327037,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2006,11,14]],"date-time":"2006-11-14T00:00:00Z","timestamp":1163462400000},"content-version":"vor","delay-in-days":4335,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Clinical Apheresis"],"published-print":{"date-parts":[[1995,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Eight pediatric patients with fulminant meningococcemia, purpura, and disseminated intravascular coagulation who by multiple prognostic scoring systems were anticipated to have a poor outcome underwent intensive plasma exchange (IPE) or whole blood exchange (WBE) in addition to standard medical therapy. IPE\/WBE was initiated shortly after admission with a mixture of both fresh frozen plasma and cryoprecipitate as the replacement solution. All IPE procedures were performed using a continuous flow system and a red cell prime. The mean fibrinogen level increased from 62 to 192 mg\/dl, the prothrombin time (PT) decreased from a mean of 32.4 seconds to 15.1 seconds, and the mean activated partial thromboplastin time (APTT) decreased from 89.5 seconds to 40.1 seconds following completion of the initial IPE\/WBE. There was a corresponding improvement in all coagulation factor levels but only slight improvement in antithrombin III (ATIII) and protein C levels. Seven of eight patients survived (87.5%) their initial presentation with the sole early death attributed to meningitis with cerebral edema. Mean fluid balance after the procedure was + 10.8 \u00b1 5.87 cc\/kg. There were no significant bleeding or cardiovascular complications during the procedure. There was no clinical or radiographic evidence of fluid overload after the procedure.<\/jats:p><jats:p>This experience demonstrates that IPE\/WBE may be conducted safely in critically ill, unstable pediatric patients and is effective in rapidly improving coagulopathy without fluid overload.<\/jats:p>","DOI":"10.1002\/jca.2920100403","type":"journal-article","created":{"date-parts":[[2007,2,21]],"date-time":"2007-02-21T16:36:05Z","timestamp":1172075765000},"page":"171-177","source":"Crossref","is-referenced-by-count":61,"title":["Intensive blood and plasma exchange for treatment of coagulopathy in meningococcemia"],"prefix":"10.1002","volume":"10","author":[{"given":"Kevin B.","family":"Churchwell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"McManus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Kent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jed","family":"Gorlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Galacki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Humphreys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherwin V.","family":"Kevy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,11,14]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/160.1.58"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198808183190703"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/inf.1971.3.issue-1.03"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(66)80250-0"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199305000-00014"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/clind\/15.3.424"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.288.6415.439"},{"issue":"178","key":"e_1_2_1_9_2","first-page":"53","article-title":"Plasmapheresis in the treatment of severe meningococcal or pneumococcal septicaemia with DIC and fibrinolysis","volume":"45","author":"Brandtzaeg P","year":"1985","journal-title":"Scand J Clin Lab Invest"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1993.33393174451.x"},{"key":"e_1_2_1_11_2","first-page":"32","article-title":"Red blood cell priming for pediatric apheresis","volume":"7","author":"Kent P","year":"1992","journal-title":"J Clin Apheresis"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-198811000-00006"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-7963(88)70035-8"},{"key":"e_1_2_1_14_2","first-page":"173","article-title":"The influence of plasma exchange on shock mediators in septicemia","volume":"8","author":"Rokke O","year":"1990","journal-title":"Surg Res Commun"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/107602969500100103"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1991.01410290067014"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70369-1"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)91728-4"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.169.1.333"}],"container-title":["Journal of Clinical Apheresis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjca.2920100403","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jca.2920100403","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,25]],"date-time":"2023-10-25T21:58:35Z","timestamp":1698271115000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jca.2920100403"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,1]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1995,1]]}},"alternative-id":["10.1002\/jca.2920100403"],"URL":"https:\/\/doi.org\/10.1002\/jca.2920100403","archive":["Portico"],"relation":{},"ISSN":["0733-2459","1098-1101"],"issn-type":[{"value":"0733-2459","type":"print"},{"value":"1098-1101","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,1]]}}}