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Related Experiment Videos

Intensive plasma exchange--effects on haemostasis

S J Urbaniak

    Progress in Clinical and Biological Research
    |January 1, 1982
    PubMed
    Summary

    Plasma exchange is safe for extended daily use, even with abnormal coagulation tests. Routine fresh frozen plasma replacement isn't needed, but monitor platelet counts for potential prophylactic treatment.

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    Area of Science:

    • Hematology
    • Transfusion Medicine
    • Critical Care

    Background:

    • Plasma exchange (PE) is a procedure used to remove plasma and replace it with substitute fluids.
    • Coagulation factor abnormalities are common in patients undergoing PE.
    • The necessity of routine fresh frozen plasma (FFP) replacement during extended PE protocols is debated.

    Purpose of the Study:

    • To evaluate the safety and efficacy of daily 4L plasma exchange using coagulation factor-free fluids for 7 or more days.
    • To assess the incidence of hemorrhagic and thrombotic complications during extended PE.
    • To determine the need for routine FFP replacement in this patient population.

    Main Methods:

    • Retrospective analysis of 815 PE procedures performed over 7 or more consecutive days.
    • Patients received 4L of coagulation factor-free fluids per exchange.
    • Coagulation screening tests and factor levels were monitored.
    • Hemorrhagic and thrombotic events were recorded.

    Main Results:

    • Extended daily PE with factor-free fluids was relatively safe.
    • Spontaneous hemorrhagic incidents occurred rarely (0.61%).
    • No thrombotic episodes were observed despite abnormal coagulation tests and factor levels.

    Conclusions:

    • Extended daily plasma exchange using coagulation factor-free fluids is a safe procedure.
    • Routine FFP replacement is not necessary for maintaining hemostasis during these protocols.
    • Prophylactic platelet concentrate administration is recommended if platelet counts drop below 30 x 10(9)/L.

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