Systematic ReviewResearchWorkflow

Plasmapheresis was linked to recovery in acute MOGAD attacks, but evidence was heterogeneous

Neurology (PubMed)Jul 22, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A systematic review of 10 publications on acute MOG antibody-associated disease found that plasmapheresis was associated with favorable visual and neurologic recovery, but high heterogeneity and nonrandomized evidence prevent causal comparisons with other acute treatments.

What NurseJet pulled from the source

The review included 1,045 patients and 1,368 attacks; eight studies with 710 patients and 1,033 attacks contributed to meta-analysis. In optic neuritis, plasmapheresis was associated with improved visual acuity and an estimated 81% excellent-recovery rate, although the confidence interval was very wide. Good recovery was also common in attacks involving myelitis or cerebral disease, and pooled plasmapheresis-related adverse effects were 3%.

Why this matters for nurses

Neurology nurses help recognize evolving visual, motor, sensory, and cerebral symptoms, establish a pre-treatment baseline, and monitor patients during escalation therapy. The review supports careful response tracking while emphasizing that pooled observational recovery rates do not identify who should receive plasmapheresis or when.

Bedside takeaway

Plasmapheresis was associated with recovery in acute MOGAD, but nonrandomized evidence cannot define comparative benefit or optimal timing.

How This Applies in Practice

Use this when: Caring for a patient receiving ordered plasmapheresis for an acute MOGAD attack.

On your shift

Document the pretreatment visual, motor, sensory, and cerebral findings available within the neurologic assessment plan.
Use the approved apheresis monitoring pathway and trend the same clinical domains across the planned treatment course.
Escalate neurologic deterioration, treatment intolerance, or new symptoms to the neurology and apheresis teams.

Keep in mind: The review does not establish comparative effectiveness, patient-selection criteria, or optimal treatment timing. Follow the apheresis protocol, facility policy, and patient-specific provider orders.

Key takeaways

Ten publications included 1,045 patients with 1,368 acute MOGAD attacks.
Eight studies contributed data for meta-analysis, including 710 patients and 1,033 attacks.
Plasmapheresis was associated with visual improvement in optic neuritis and favorable recovery in other attack presentations.
High heterogeneity, variable timing and severity, and the absence of randomized comparisons limit treatment-effect and safety conclusions.

Practice implications

Document the neurologic and visual baseline before treatment when feasible, follow the ordered plasmapheresis monitoring pathway, and trend the same clinical domains across exchanges. Escalate deterioration, treatment intolerance, or new symptoms promptly through the neurology and apheresis teams.

Limitations & cautions

The evidence came from heterogeneous, nonrandomized studies with differences in attack type, severity, prior treatment, plasmapheresis timing, and outcome definitions. Recovery estimates had wide intervals, confounding by treatment selection is likely, and a low pooled adverse-effect rate cannot establish comparative safety.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

Open source

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Neurology (PubMed)

Neurology (PubMed). Effectiveness and Safety of Plasmapheresis in MOGAD Attacks: A Systematic Review and Meta-Analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42485605/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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A double-blind randomized trial found no reduction in vomiting or faster oral tolerance with intravenous pantoprazole versus placebo in children with acute gastroenteritis and persistent vomiting after ondansetron.

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The trial randomized 100 children. Vomiting episodes and oral tolerance at 6 and 12 hours did not differ significantly, while median hospital stay was 2 days with pantoprazole and 1 day with placebo.

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The median participant age was 14 months, and 67% of participants were male.
Oral tolerance at 12 hours was 86% in both groups.
The longer stay associated with pantoprazole requires cautious interpretation because this was a single-center trial.

Why this matters on shift

The trial does not support empiric intravenous proton-pump inhibition for persistent vomiting in pediatric acute gastroenteritis after ondansetron.

Bedside takeaway

Clarify the indication for empiric acid suppression and keep hydration and oral-tolerance assessment central to care.

Nursing implications

Prioritize the ordered hydration and oral-tolerance plan, document ongoing emesis, and clarify the indication before administering empiric acid suppression.

Limitations & cautions

Abstract-only summary. This was a single-center study of 100 children in Tehran, and the abstract does not describe adverse events or explain why hospitalization was longer in the pantoprazole group.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pediatric emergency care (PubMed). Effect of Intravenous Pantoprazole on Clinical Outcomes in Pediatric Acute Gastroenteritis: A Placebo-Controlled RCT.

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AI-summarized from the linked source. Review the original article before applying to practice.

Journal of neurosurgical anesthesiology (PubMed)Sep 4, 2026Research Article

A five-center randomized trial found similar rescue-opioid use and moderate-to-severe PACU pain with dexmedetomidine-based opioid-sparing analgesia and fentanyl-based analgesia during elective craniotomy for brain tumors.

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The trial randomized 500 adults. Moderate-to-severe PACU pain occurred in 145 of 242 assessed participants in the fentanyl group and 138 of 233 in the dexmedetomidine group, with no significant difference.

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Intraoperative rescue fentanyl use did not differ significantly between groups.
Hypotension was more common with dexmedetomidine, while postoperative shivering was less common.
Other in-hospital outcomes were similar between the two regimens.

Why this matters on shift

An opioid-sparing label did not translate into better early pain control in this trial, and the differing hypotension and shivering profiles remain relevant during perioperative handoff and recovery monitoring.

Bedside takeaway

Monitor pain, hemodynamics, sedation, and shivering in relation to the analgesic regimen and local protocol.

Nursing implications

During PACU and postoperative handoff, monitor pain, hemodynamics, sedation, and shivering according to the administered regimen and local protocol.

Limitations & cautions

Abstract-only summary. The trial involved elective tumor craniotomy at five Indian centers, both groups also received locoregional analgesia, and the abstract does not provide longer-term outcome results in detail.
AI-summarized from the linked source. Review the original article before applying to practice.

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Journal of neurosurgical anesthesiology (PubMed). Opioid-Sparing Versus Opioid-Based Analgesia for Craniotomy: A Multicenter Randomized Controlled Trial.

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A multicountry emergency-department analysis found that older patients' presenting complaints did not by themselves reflect underlying severity or disposition risk.

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The analysis included 2,794 adults aged 65 or older with one non-traumatic chief complaint across 36 emergency departments in nine European countries. Shortness of breath was associated with threefold admission odds and 2.2-fold in-hospital mortality odds.

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Shortness of breath, abdominal pain, chest pain, weakness or fatigue, and extremity symptoms accounted for 59% of presentations.
Age 85 or older, geriatric risk factors, polypharmacy, and shortness of breath were associated with admission.
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Why this matters on shift

A seemingly routine complaint can coexist with frailty, polypharmacy, cognitive impairment, or other risks that change emergency assessment and disposition planning.

Bedside takeaway

Pair the presenting complaint with structured geriatric, medication, cognitive, functional, and physiologic assessment.

Nursing implications

Pair the chief complaint with structured geriatric, medication, cognitive, functional, and physiologic assessment using local emergency protocols.

Limitations & cautions

Abstract-only summary. This was a secondary observational analysis of seven-day samples collected during the 2020 COVID-19 pandemic; associations do not prove causation and may not generalize to all emergency settings.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

BMC geriatrics (PubMed). Non-traumatic chief complaints in older patients in European emergency departments and associated outcomes during the Covid-19 pandemic - a secondary analysis of the cross sectional EGERS study.

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

More updates for this clinical area

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