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Replacement fluids in plasmapheresis: cross-over comparative study
P Le Conte1, F Nicolas, C Adjou
1Service de Réanimation Médicale, Centre Hôspitalier Universitaire, Nantes, France.
Objective:
To compare the tolerance and the cost of three replacement fluids in plasmapheresis: albumin 4% alone, albumin 4% + dextran 40, or albumin 4% + hydroxyethylstarch 6%.
Design:
A one center randomized, cross-over, comparative study designed to explore the tolerance and the colloid oncotic pressure in patients undergoing plasmapheresis.
Patients:
225 plasmapheresis procedures were performed in 27 patients.
Measurements And Results:
Hemodynamic tolerance was good in the three treatment groups. Serum protein concentration after plasmapheresis was significantly lower in the albumin + hydroxyethylstarch group, followed by albumin + dextran 40, versus albumin alone. Colloid oncotic pressure before and after exchange was similar in the three groups.
Conclusions:
The clinical use of 25-30% of hydroxyethylstarch 6% or dextran 40 with albumin 4% was clinically well tolerated and associated with a 12% decrease of the cost of substitution solutions.