Plasma exchange and critical autoimmune diseases

Experience of a second-level center in Quito-Ecuador.

Abstract

Introduction: Renal replacement therapy (RRT) has evolved significantly since its introduction; initially used to treat acute renal failure, it is applied in various clinical scenarios due to improved membranes and equipment. Other techniques have emerged, such as therapeutic apheresis and hemoadsorption, which allow specific components to be removed from the blood. These therapies have shown promise in the treatment of various diseases.

Important points:

Sepsis and septic shock are the most common causes of admission to intensive care units (ICU), and extracorporeal therapies (ECT) have shown promise in their management.

Sepsis is characterized by a dysregulated inflammatory response, which can lead to multiorgan damage. ECT can help modulate this response, eliminating inflammatory mediators and restoring immune balance.

Although clinical evidence is inconclusive for all indications, studies have shown improvements in clinical parameters, such as decreased need for vasopressors and improved oxygenation.

The response to ECT may be variable between patients due to genetic, epigenetic, and sociodemographic factors.

Conclusion: extracorporeal therapies are presented as a promising tool in the management of critically ill patients, and their use is expanding beyond sepsis. As more scientific evidence accumulates, it is expected that these techniques will become consolidated as part of the standard treatment in various pathologies.