Experience of Plasmapheresis Performed with Crrt Monitors by Icu Staff

Results A total of 49 sessions were performed in 5 patients with neurological disease. 80% of our patients were female. Median age: 42 (IQR 35-71) years. Median number of sessions in each cycle: 4 (range 3-6). Plasma volume exchange ratio was 1:1. Replacement fluid used was Hemosol B0 TM (Gambro) with addition of albumin (to achieve a concentration of 3-4 g/dL) and KCl (4.1 ± 0.3 mmol/L). Session mean duration: 2.9 ± 0.1 hours. During PF, a decrease (p < 0.05) in systolic BP (124 ± 17 to 113 ± 19 mmHg) and diastolic BP (68 ± 11 to 62 ± 10 mmHg) was observed. Nevertheless, norepinephrine up to 0.27 mcg/kg/min was only necessary in 10% (5/49) of the sessions. Main significant analytical results in Table 1. Transient significant leukocytosis with no signs of infection developed after PF. This was due to an increase in the neutrophils count (6.4 ± 2.5 to 12.4 ± 5.3 cells 10/μL,p < 0.05); lymphocytes trend to decrease although without reaching statistical significance (1.9 ± 1.5 to 1.6 ± 1 cells 10/μL,p= 0.09). Although serum Sodium and Chloride varied significantly with PF, their levels remained within normal ranges, whereas serum Potassium remained stable due to replacement fluid concentration administered. Red blood cell transfusion was accomplished in 8.2%(4/ 49), platelets transfusion in 2%(1/49) and fresh-frozen plasma transfusion in 6%(3/49) of the sessions. A mean fibrinogen concentrate dose of 1.9 ± 1.2g. was administrated in 59.2%(29/49) of the sessions. Electrolytes disturbances were corrected based on medical criteria. Complications detected were coagulation of extracorporeal system(n = 1), catheter thrombosis(n = 1) and femoral catheter contamination(n = 1) due to indwelling catheter urinary tract infection. No major bleeding, or therapy-related deaths were registered.