Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura
- Author
- Elie Azoulay, Philippe R. Bauer, Eric Mariotte, Lene Russell, Paul Knoebl, Ignacio Martin-Loeches, Frédéric Pène, Kathryn Puxty, Pedro Povoa, Andreas Barratt-Due, Jose Garnacho-Montero, Julia Wendon, Laveena Munshi, Dominique Benoit (UGent) , Michael von Bergwelt-Baildon, Marco Maggiorini, Paul Coppo, Spero Cataland, Agnès Veyradier and Andry Van de Louw
- 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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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-8632431
- MLA
- Azoulay, Elie, 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, doi:10.1007/s00134-019-05736-5.
- APA
- Azoulay, E., Bauer, P. R., Mariotte, E., Russell, L., Knoebl, P., Martin-Loeches, I., … Van de Louw, A. (2019). Expert statement on the ICU management of patients with thrombotic thrombocytopenic purpura. INTENSIVE CARE MEDICINE, 45(11), 1518–1539. https://doi.org/10.1007/s00134-019-05736-5
- Chicago author-date
- Azoulay, Elie, Philippe R. Bauer, Eric Mariotte, Lene Russell, Paul Knoebl, Ignacio Martin-Loeches, Frédéric Pène, et al. 2019. “Expert Statement on the ICU Management of Patients with Thrombotic Thrombocytopenic Purpura.” INTENSIVE CARE MEDICINE 45 (11): 1518–39. https://doi.org/10.1007/s00134-019-05736-5.
- Chicago author-date (all authors)
- Azoulay, Elie, Philippe R. Bauer, Eric Mariotte, Lene Russell, Paul Knoebl, Ignacio Martin-Loeches, Frédéric Pène, Kathryn Puxty, Pedro Povoa, Andreas Barratt-Due, Jose Garnacho-Montero, Julia Wendon, Laveena Munshi, Dominique Benoit, Michael von Bergwelt-Baildon, Marco Maggiorini, Paul Coppo, Spero Cataland, Agnès Veyradier, and Andry Van de Louw. 2019. “Expert Statement on the ICU Management of Patients with Thrombotic Thrombocytopenic Purpura.” INTENSIVE CARE MEDICINE 45 (11): 1518–1539. doi:10.1007/s00134-019-05736-5.
- Vancouver
- 1.Azoulay E, Bauer PR, 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, Elie and Bauer, Philippe R. and Mariotte, Eric and Russell, Lene and Knoebl, Paul and Martin-Loeches, Ignacio and Pène, Frédéric and Puxty, Kathryn and Povoa, Pedro and Barratt-Due, Andreas and Garnacho-Montero, Jose and Wendon, Julia and Munshi, Laveena and Benoit, Dominique and von Bergwelt-Baildon, Michael and Maggiorini, Marco and Coppo, Paul and Cataland, Spero and Veyradier, Agnès and Van de Louw, Andry}},
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://doi.org/10.1007/s00134-019-05736-5}},
volume = {{45}},
year = {{2019}},
}
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