[Preliminary evaluation of erythrapheresis in the treatment of chronic cor pulmonale]

Reduction of polyglobulia is one of the principal rules in therapeutic management of decompensated cor pulmonale syndrome. In the Department of Internal Diseases, Medical Academy in Cracow since over two years erythrocytapheresis was used in 27 cases as an adjunct therapy with oxygen and pharmacological treatment. The criteria qualifying for this procedure were: haematocrit over 60%, hemoglobin over 160 g/l, erythrocytosis over 5.0 x 10(9)/l. The procedure was carried out as follows: from a peripheral vein about 450 ml of whole blood was taken each time into a special container made by Fenwal (USA) containing CPD solution, and was centrifuged for 20 minutes at 1500 r.p.m. After centrifugation plasma was reinfused. Erythrocytapheresis was done at intervals of 2-3 days, and its number was determined by the degree of polyglobulia. In patients with very high values of haematocrit, haemoglobin and erythrocyte count the procedure was done using a Progress BT 790 A separator. The separator made possible an earlier normalization of these parameters, since several separations could be done on one day. The treatment was followed by earlier improvement of wellbeing, longer duration of normal values of blood cells, considerable improvement of gasometric indices, regression of or reduction of central cyanosis, earlier regression of peripheral oedema disappearance of coexistent left-ventricular failure, increased effort tolerance, regression of features of right-ventricular strain. In the light of observations collected as yet it may be concluded that combination of treatment with erythrocytopheresis and typical pharmacotherapy should be the basic method of treatment in chronic advanced cor pulmonale syndrome.