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Related Experiment Videos

Partial colloid starch replacement for therapeutic plasma exchange

H G Owen1, M E Brecher

  • 1Apheresis Transfusion Medicine Service, University of North Carolina School of Medicine, Chapel Hill 27514, USA.

Journal of Clinical Apheresis
|January 1, 1997
PubMed
Summary
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Hetastarch (HES) solutions offer a safe and cost-effective alternative to protein solutions for partial replacement during therapeutic plasma exchange (TPE). Three percent HES demonstrated stable blood pressure and pulse in most procedures, making it a viable option.

Area of Science:

  • Nephrology
  • Neurology
  • Hematology

Background:

  • Protein solutions are the standard replacement fluid in therapeutic plasma exchange (TPE).
  • Neurology patients often require full replacement with 5% protein solutions due to autonomic instability.
  • Product shortages and rising costs of protein solutions necessitate exploring alternatives.

Purpose of the Study:

  • To evaluate the safety and efficacy of using 6% and 3% hetastarch (HES) as partial replacement fluids during TPE.
  • To compare the outcomes of HES replacement with traditional protein solutions in adult neurology patients.

Main Methods:

  • Adult neurology patients with normal organ function were included.
  • Patients received 1000 ml of either 6% HES or 3% HES as part of their TPE replacement fluid.

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  • Patients were monitored for peripheral edema, bleeding, rash, and subjective changes.
  • Laboratory values (total protein, albumin, osmolality, PT, aPTT) were assessed in a subset of patients.

    • Main Results:

    • Both 6% and 3% HES groups showed a drop in total protein, with other lab values normalizing within 48 hours.
    • The 3% HES group maintained stable blood pressure and pulse in 97.3% of procedures.
    • One patient experienced mild peripheral edema; transient back and head pain occurred in a few patients during HES infusion.
    • No evidence of bleeding or significant subjective changes was observed.

    Conclusions:

    • Three percent hetastarch (HES) is a safe and cost-effective partial replacement for albumin during therapeutic plasma exchange (TPE).
    • HES can be considered a viable alternative to protein solutions, particularly for neurology patients.
    • Further research may explore optimal HES concentrations and patient selection criteria.