Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal

Authors

  • Rita Faria Intensive Care Department. Hospital Beatriz Ângelo. Loures.
  • Alexei Bucur Intensive Care Department. Hospital Beatriz Ângelo. Loures.
  • André Gordinho Intensive Care Department. Hospital Beatriz Ângelo. Loures.
  • Luis Falcão Nephrology Department. Hospital Beatriz Ângelo. Loures.
  • André Carrão Anaesthesiology Department. Hospital Beatriz Ângelo. Loures.
  • Sara Fernandes Nephrology Department. Hospital Beatriz Ângelo. Loures.
  • João Pedro Colaço Intensive Care Department. Hospital da Luz. Lisboa.
  • Carlos Meneses-Oliveira Intensive Care Department. Hospital Beatriz Ângelo. Loures.
  • António Messias Intensive Care Department. Hospital da Luz. Lisboa.

DOI:

https://doi.org/10.20344/amp.14266

Keywords:

Critical Illness/therapy, Plasma Exchange/methods, Plasmapheresis/adverse effects, Plasmapheresis/methods, Plasmapheresis /therapeutic use

Abstract

Introduction: Therapeutic plasmapheresis is a therapeutic procedure in which the patient’s blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit.
Material and Methods: An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded.
Results: Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresis session due to complications related to the patient.
Conclusion: Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.

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Published

2022-03-02

How to Cite

1.
Faria R, Bucur A, Gordinho A, Falcão L, Carrão A, Fernandes S, Colaço JP, Meneses-Oliveira C, Messias A. Therapeutic Plasmapheresis: Seven Year Experience of an Intensive Care Unit in Portugal. Acta Med Port [Internet]. 2022 Mar. 2 [cited 2023 Feb. 9];35(3):176-83. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/14266

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Section

Original