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Related Experiment Videos

Hemodynamic evaluation during plasma-exchange with intermittent flow.

U Coli, S Landini, A Fracasso

    The International Journal of Artificial Organs
    |July 1, 1983
    PubMed
    Summary

    Plasma exchange (PE) can cause hemodynamic changes. Replacing fluid during each cycle prevents complications like hypovolemic shock and heart failure during PE therapy.

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    Area of Science:

    • Nephrology
    • Cardiovascular Physiology

    Background:

    • Plasma exchange (PE) is a therapeutic method for immunological nephropathies and poisonings.
    • Hemodynamic monitoring is crucial during PE to manage potential complications.

    Purpose of the Study:

    • To investigate hemodynamic changes during intermittent flow plasma exchange.
    • To identify strategies for preventing hemodynamic complications during PE.

    Main Methods:

    • Studied 8 patients undergoing intermittent flow plasma exchange using thermodilution.
    • Measured hemodynamic parameters including mean arterial pressure, cardiac index, and pressures before, during, and after each exchange cycle.

    Main Results:

    • The initial exchange caused acute hemorrhagic-like changes: decreased blood pressure, cardiac output, and venous pressure, with increased peripheral resistance.

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  • Subsequent cycles showed parameter normalization, but pulmonary arterial pressure increased over time.
  • Low-volume fluid replacement per cycle is critical.

    • Conclusions:

    • Plasma exchange can induce significant, transient hemodynamic alterations.
    • Continuous fluid replacement during each cycle of plasma exchange is essential to prevent hypovolemic shock and heart failure.