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Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura.

(2019) INTENSIVE CARE MEDICINE. 45(11). p.1518-1539
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Organization
Abstract
Thrombotic thrombocytopenic purpura (TTP) is fatal in 90% of patients if left untreated and must be diagnosed early to optimize patient outcomes. However, the very low incidence of TTP is an obstacle to the development of evidence-based clinical practice recommendations, and the very wide variability in survival rates across centers may be partly ascribable to differences in management strategies due to insufficient guidance. We therefore developed an expert statement to provide trustworthy guidance about the management of critically ill patients with TTP. As strong evidence was difficult to find in the literature, consensus building among experts could not be reported for most of the items. This expert statement is timely given the recent advances in the treatment of TTP, such as the use of rituximab and of the recently licensed drug caplacizumab, whose benefits will be maximized if the other components of the management strategy follow a standardized pattern. Finally, unanswered questions are identified as topics of future research on TTP.
Keywords
Cardiac failure, Auto-immune disease, Thrombocytopenia, Hemolysis, Acute kidney injury, Plasma exchange. HEMOLYTIC-UREMIC SYNDROME, SEVERE ADAMTS13 DEFICIENCY, FACTOR-CLEAVING PROTEASE, DAILY PLASMA-EXCHANGE, SUBOPTIMAL RESPONSE, ORGAN DYSFUNCTION, RENAL-FAILURE, ACUTE-PHASE, RITUXIMAB, MICROANGIOPATHIES

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MLA
Azoulay, E., et al. “Expert Statement on the ICU Management of Patients with Thrombotic Thrombocytopenic Purpura.” INTENSIVE CARE MEDICINE, vol. 45, no. 11, 2019, pp. 1518–39.
APA
Azoulay, E., Bauer, P., Mariotte, E., Russell, L., Knoebl, P., Martin-Loeches, I., … Investigators, N. (2019). Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura. INTENSIVE CARE MEDICINE, 45(11), 1518–1539.
Chicago author-date
Azoulay, E, PR Bauer, E Mariotte, L Russell, P Knoebl, I Martin-Loeches, F Pène, et al. 2019. “Expert Statement on the ICU Management of Patients with Thrombotic Thrombocytopenic Purpura.” INTENSIVE CARE MEDICINE 45 (11): 1518–39.
Chicago author-date (all authors)
Azoulay, E, PR Bauer, E Mariotte, L Russell, P Knoebl, I Martin-Loeches, F Pène, K Puxty, P Povoa, A Barratt-Due, J Garnacho-Montero, J Wendon, L Munshi, Dominique Benoit, M von Bergwelt-Baildon, M Maggiorini, P Coppo, S Cataland, A Veyradier, A Van de Louw, and Nine-i Investigators. 2019. “Expert Statement on the ICU Management of Patients with Thrombotic Thrombocytopenic Purpura.” INTENSIVE CARE MEDICINE 45 (11): 1518–1539.
Vancouver
1.
Azoulay E, Bauer P, Mariotte E, Russell L, Knoebl P, Martin-Loeches I, et al. Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura. INTENSIVE CARE MEDICINE. 2019;45(11):1518–39.
IEEE
[1]
E. Azoulay et al., “Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura.,” INTENSIVE CARE MEDICINE, vol. 45, no. 11, pp. 1518–1539, 2019.
@article{8632431,
  abstract     = {Thrombotic thrombocytopenic purpura (TTP) is fatal in 90% of patients if left untreated and must be diagnosed early to optimize patient outcomes. However, the very low incidence of TTP is an obstacle to the development of evidence-based clinical practice recommendations, and the very wide variability in survival rates across centers may be partly ascribable to differences in management strategies due to insufficient guidance. We therefore developed an expert statement to provide trustworthy guidance about the management of critically ill patients with TTP. As strong evidence was difficult to find in the literature, consensus building among experts could not be reported for most of the items. This expert statement is timely given the recent advances in the treatment of TTP, such as the use of rituximab and of the recently licensed drug caplacizumab, whose benefits will be maximized if the other components of the management strategy follow a standardized pattern. Finally, unanswered questions are identified as topics of future research on TTP.},
  author       = {Azoulay, E and Bauer, PR and Mariotte, E and Russell, L and Knoebl, P and Martin-Loeches, I and Pène, F and Puxty, K and Povoa, P and Barratt-Due, A and Garnacho-Montero, J and Wendon, J and Munshi, L and Benoit, Dominique and von Bergwelt-Baildon, M and Maggiorini, M and Coppo, P and Cataland, S and Veyradier, A and Van de Louw, A and Investigators, Nine-i},
  issn         = {0342-4642},
  journal      = {INTENSIVE CARE MEDICINE},
  keywords     = {Cardiac failure,Auto-immune disease,Thrombocytopenia,Hemolysis,Acute kidney injury,Plasma exchange. HEMOLYTIC-UREMIC SYNDROME,SEVERE ADAMTS13 DEFICIENCY,FACTOR-CLEAVING PROTEASE,DAILY PLASMA-EXCHANGE,SUBOPTIMAL RESPONSE,ORGAN DYSFUNCTION,RENAL-FAILURE,ACUTE-PHASE,RITUXIMAB,MICROANGIOPATHIES},
  language     = {eng},
  number       = {11},
  pages        = {1518--1539},
  title        = {Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura.},
  url          = {http://dx.doi.org/10.1007/s00134-019-05736-5},
  volume       = {45},
  year         = {2019},
}

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