Management dilemma in choosing evolving treatments in neutropenic septic shock.
How does a physician decide to use a recently FDA-approved life-saving device in a desperately ill child in which little prior clinical experience is available? This report presents a pediatric patient with neutropenic septic shock and multiorgan failure (MOF) with a 95% chance of death and the avai...
| Publicado en: | Pediatric Nephrology Vol. 40; no. 11; pp. 3577 - 3584 |
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| Autores principales: | , , , , , , |
| Formato: | case study pictorial tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188353541&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188353541 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Nov2025 vid: 40 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 188353541 186044768 188353541 188353541 10.1007/s00467-025-06798-y 188353541 ppf: 3577 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Management dilemma in choosing evolving treatments in neutropenic septic shock. aug: au: Humes, H. David Luckritz, Kera Gorga, Stephen Plomaritas, Katie Hoatlin, Sara Humes, Michael Yessayan, Lenar affil: https://ror.org/00jmfr291 Department of Internal Medicine (Nephrology), University of Michigan, Ann Arbor, MI, USA sug: subj: Neutropenia Therapy Shock, Septic Therapy Multiple Organ Dysfunction Syndrome Therapy Cell Therapy Decision Making, Clinical Multiple Organ Dysfunction Syndrome Immunology Neutropenia Complications Shock, Septic Immunology Immunologic Factors Male Child Kidney Transplantation Renal Insufficiency, Chronic Surgery Induction Chemotherapy Magnetic Resonance Imaging Lymphoma, B-Cell Diagnosis Positron-Emission Tomography Disseminated Intravascular Coagulation Diagnosis Shock, Septic Diagnosis Multiple Organ Dysfunction Syndrome Diagnosis Treatment Outcomes Critically Ill Patients Shock, Septic Etiology Multiple Organ Dysfunction Syndrome Etiology Neutrophils Immunology Child: 6-12 years Male ab: How does a physician decide to use a recently FDA-approved life-saving device in a desperately ill child in which little prior clinical experience is available? This report presents a pediatric patient with neutropenic septic shock and multiorgan failure (MOF) with a 95% chance of death and the availability of a therapeutic device with a completely new approach to treat sepsis. This device, called the selective cytopheretic device (SCD), is a first-in-class autologous immune cell directed therapy. The SCD, when integrated into an extracorporeal blood circuit, has been shown to bind activated neutrophils and monocytes. With a simple pharmacologic maneuver within the device, the bound cells in real time are immunomodulated from a highly pro-inflammatory state to a less inflammatory phenotype. These transformed cells are then released back into the systemic circulation thereby tempering the systemic hyperinflammatory disorder. Since this cell directed therapy focuses on neutrophils, the processing of these cells in a neutropenic state may be a substantive risk resulting in further immunosuppression. On the other hand, the immunomodulation of the circulating neutrophils and monocytes, although sparse, may be beneficial to disrupt the dysregulated inflammatory state responsible for ongoing tissue damage and organ dysfunction. Prior clinical SCD trials excluded patients with neutropenia so that no prior clinical experience was available to make a difficult decision. This report presents the way the medical team approached these issues and made a therapeutic plan that resulted in a positive clinical outcome for the patient. pubtype: Academic Journal doctype: case study pictorial tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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