Complications of Pediatric Apheresis.
Bibliographic record
Abstract
Objectives Even if the practice and applications of apheresis have grown over the last decade, the data in pediatrics are limited. The frequency of the complications is low in adults but there is a lack of clinical trials assessing the nature and the frequency of the complications in children. Methods We have revised the medical files of all patients (0–18 years old) who have undergone an apheresis at Ste-Justine Hospital (pediatric hospital in Montreal, Canada) between November 1994 and July 2002. The reported complications were: symptoms of hypocalcemia, hypotensions (drop of systolic BP ≥10 mmg Hg), complications of the vascular access (thrombosis and infection), reactions to blood products and severe anemia. Results A total of 1632 aphereis were performed on 186 different patients (32 distinct diagnosis). The procedures were plasma exchange (67%), peripheral blood stem cells collect (18%), red cell exchange (6,9%), cytoreduction leucapheresis (0,7%) and immunoadsorption (6,7%). Adverse reactions, although mostly minor, were reported in most of the patients. The more frequent complications were hypotensions (14% of apheresis and 48,4% of patients), hypotensions which needed bolus (4,8% of apheresis and 26,9% of patients) , symptoms of hypocalcemia (9,7% and 28,5%), allergic reactions (4,4% and 5,9%) and troubles related to the vascular access: infection (2,1% and 16,1%) and thrombosis (1,7% and 12,4%). A severe anemia (Hb < 70g/L) complicated 2,5% of apheresis (17,2% of patients). There were two deaths related to procedures. With a multivariate analysis, we have identified independent risk factors for occurence of complications: lower weight, lower hemoglobin pre-pheresis, pheresis in ICU and number of pheresis. Conclusion The incidence of complications of apheresis in our pediatric cohort is much higher than what is reported in adults. The adverse reactions can be explained by the citrate toxicity, the extravascular volume shift and the vascular access installed. We consider that apheresis in pediatrics present unique features and should be done in specialized centers.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".