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Plasma exchange with prostaglandin I2 and ACD solution: comparative effects.
The International Journal of Artificial Organs
|November 1, 1986
Summary
Plasma exchange using prostaglandin I2 (PGI2) with heparin maintained normal clotting times. PGI2 treatment reduced platelet aggregation without decreasing platelet count, unlike ACD solution alone.
Area of Science:
- Hematology
- Cardiovascular Medicine
- Nephrology
Background:
- Plasma exchange is a critical procedure for various medical conditions.
- Optimizing anticoagulation and minimizing side effects during plasma exchange is essential.
- Prostaglandin I2 (PGI2) and heparin are used as anticoagulants, but their effects on platelet function require investigation.
Purpose of the Study:
- To compare the effects of discontinuous plasma exchange with PGI2 and heparin (Treatment I) versus ACD solution alone (Treatment II) on platelet count and aggregation.
- To evaluate the safety of PGI2 at a dosage of 5 ng/kg/min during plasma exchange.
- To discuss the physiopathological implications of observed differences in platelet behavior.
Main Methods:
- Two treatment groups underwent discontinuous plasma exchange.
- Treatment I involved PGI2 (5 ng/kg/min) and low-dose heparin (5-6 IU/kg/min).
- Treatment II involved ACD solution alone. Activated partial thromboplastin time (aPTTT) was monitored, and platelet count and in vitro platelet aggregation were assessed post-treatment.
Main Results:
- Activated partial thromboplastin time remained within the normal range during both treatments.
- Treatment I (PGI2 and heparin) did not decrease platelet count but significantly reduced in vitro platelet aggregation (p < 0.001).
- Treatment II (ACD solution) resulted in a reduced platelet count with unchanged in vitro platelet aggregation. No cardiovascular complications were observed with PGI2.
Conclusions:
- Discontinuous plasma exchange with PGI2 and low-dose heparin effectively reduces platelet aggregation without compromising platelet count.
- This PGI2-based regimen appears safer and more effective in preserving platelet function compared to ACD solution alone during plasma exchange.
- The findings suggest potential benefits of PGI2 in plasma exchange protocols, warranting further investigation into its physiopathological mechanisms.