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A simple and accurate method for prescribing plasma exchange.

A A Kaplan1

  • 1Department of Medicine, University of Connecticut School of Medicine, Farmington.

ASAIO Transactions
|July 1, 1990
PubMed
Summary

A simplified formula for estimating plasma volume (EPV) allows for reliable prediction of plasma exchange treatment outcomes. This method accurately forecasts the decline in serum levels of large molecules like immunoglobulins and cholesterol.

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Area of Science:

  • Nephrology
  • Immunology
  • Biochemistry

Background:

  • Plasma exchange (PLEX) is a therapeutic apheresis procedure.
  • Accurate prediction of PLEX outcomes requires estimating plasma volume (EPV).

Purpose of the Study:

  • To evaluate a simplified formula for EPV calculation.
  • To assess the reliability of predicted versus actual serum level declines of large molecules during PLEX.

Main Methods:

  • A simplified EPV formula (EPV = [0.065 X wt(kg)] X [1-Hct]) was used.
  • Serum levels of IgG, IgA, IgM, C3, and total cholesterol were measured before and after PLEX.
  • Predicted and actual percentage declines were compared over 102 treatments in 18 patients.

Main Results:

  • Predicted vs. actual IgG decline: 67% vs. 64%.
  • Predicted vs. actual IgA decline: 66% vs. 66%.
  • Predicted vs. actual IgM decline: 66% vs. 69%.
  • Predicted vs. actual C3 decline: 58% vs. 61%.
  • Predicted vs. actual total cholesterol decline: 66% vs. 70%.

Conclusions:

  • The simplified EPV estimation method provides reasonably reliable predictions of PLEX treatment results.
  • This formula aids in forecasting the effectiveness of PLEX for various large molecular substances.

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