Pengaruh Therapeutic Plasma Exchange terhadap Luaran Pasien dengan Autoimun Neurologis yang Dirawat di ICU RS Adam Malik Medan

Abstract

Background: Therapeutic plasma exchange (TPE) eliminates circulating pathogenic substances such as autoantibodies from the bloodstream, thereby improving clinical outcomes. Diseases such as Myasthenia Gravis and Guillain-Barre Syndrome often cause paralysis that requires intensive care, one of the expected uses is TPE. The purpose of this study was to determine the effect of TPE on the outcome of patients with neurological autoimmunity treated at Adam Malik Hospital Medan. Method: An analytical retrospective study was conducted on patients withneurological autoimmune disorders who underwent TPE and were ventilated at Haji Adam Malik Hospital Medan. Demographic data, clinical outcomes, duration of ventilator use, assessment of changes in neurological autoimmune scores using the Myasthenia Composite Scale (MCS) and Guillain Barre Disability Scale (GBDS) before and after TPE (1-2 cycles) were analyzed using descriptive and inferential statistical methods. Results: Of the 22 patients who underwent TPE, 16 people with myasthenia gravis underwent TPE and 9 people with Guillain Barre Syndrome underwent TPE, but no significant difference was found between the two (p>0.05). On the contrary, there wasa decrease in MCS values after TPE, a significant difference was found between the two groups (p<0.05). Discussion: These findings support the hypothesis that TPE is effective in improving outcomes in patients with neurological autoimmune disease. The mechanism of actionof TPE, which removes pathogenic substances from the blood, contributes to the improvement of patient conditions. This study is in line with the ASFA recommendation that TPE is the therapy of choice for certain conditions. Conclusion: TPE has been shown to have a positive impact on the outcome of patients with neurological autoimmune in the ICU of Adam Malik Hospital medan. Further research is needed to explore the long-term effects and optimization of TPE protocols in this population.