Abstract: Objective  To analyze the application of therapeutic plasma exchange (TPE) and its complications in pediatric renal rheumatic diseases, and to explore the relevant nursing strategies.  Methods The children undergoing TPE at the Department of Nephrology and Rheumatology, Fudan University Children's Hospital from January 2021 to December 2022 were retrospectively studied. Informed consent was obtained from the family of the patient. Vascular access was established through an internal jugular vein. The Prismaflex blood purification machine was used to perform TPE in a total of 28 times for 9 patients. The primary diseases of the patients, pre- and post-TPE indicators, and the presence of complications were analyzed. Results Complications occurred in the 28 times of TPE for the 9 patients, including allergic reactions 9 times (32.1%), hypocalcemia 9 times (32.1%), hypotension 4 times (14.2%), coagulation in extracorporeal circulation once (3.6%), and catheter malfunction once (3.6%). After appropriate nursing interventions, the complications were resolved, and TPE treatments completed successfully without any other life-threatening events.  Conclusion  In the processes of TPE, clinical efficacy on children with different diseases should be observed, and TPE complications should be monitored and managed by appropriate nursing interventions to minimize the side-effects of complications, and to ensure the safety and efficacy of TPE.

Key words: Therapeutic plasma exchange, Pediatric patient, Complication, Nursing intervention