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Hemolysis in double-filtration plasmapheresis
Jiann-Horng Yeh1, Wei-Hung Chen, Hou-Chang Chiu
1Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
American Journal of Clinical Pathology
|December 6, 2006
Summary
Hemolysis occurred in 35.4% of patients during double-filtration plasmapheresis (DFP). Higher transmembrane pressure and peripheral venous access increased hemolysis risk, suggesting large vein access and stable pressure can improve safety.
Area of Science:
- Nephrology
- Neurology
Background:
- Double-filtration plasmapheresis (DFP) is used to treat myasthenia gravis.
- Hemolysis is a potential complication during DFP procedures.
Purpose of the Study:
- To evaluate the occurrence and causes of hemolysis during DFP in myasthenic patients.
- To identify factors associated with hemolysis during DFP.
Main Methods:
- Prospective study of 113 myasthenic patients undergoing DFP.
- Monitoring of transmembrane pressure (TMP), arterial line pressure (Pa), and venous line pressure (Pv) at 30-minute intervals.
- Analysis of laboratory and clinical parameters related to hemolysis.
Main Results:
- Overall hemolysis frequency was 35.4%.
- Peripheral venous access was associated with a higher hemolysis rate (45.3%).
- Mean TMP and Pa increased significantly in the hemolysis group compared to the no-hemolysis group, particularly after 30 minutes.
Conclusions:
- Hemolysis is a common complication of DFP in myasthenia gravis patients.
- Elevated TMP and Pa, along with peripheral venous access, are risk factors for hemolysis.
- Utilizing large vein vascular access and maintaining stable TMP may help prevent DFP-associated hemolysis.
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