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Plasma Exchange - PowerPoint PPT Presentation


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Plasma Exchange consists of the removal of large volumes of the patient' s plasma and replacing it with exogenous plasma or plasma substitutes Action: removes from the circulation any pathogenic material decrease T lymphocytes (indirect action) normalize abnormal T4/T8 ratio (indirect).

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slide1

Plasma Exchange

  • consists of the removal of large volumes of the patient' s plasma and replacing it with exogenous plasma or plasma substitutes
    • Action:
      • removes from the circulation any pathogenic material
      • decrease T lymphocytes (indirect action)
      • normalize abnormal T4/T8 ratio (indirect)
slide2

In 10 Pxs with PG treated with plasma exchange once to three times weekly for a total of 4 to 27 exchanges

- (7) excellent response

- (3) incomplete or no response

slide3

Potential complications include:

  • vasovagal reactions
  • hypovolemia or fluid
  • overload,
  • electrolyte abnormalities
  • infection of indwelling lines,
  • bleeding tendency caused by depletion of platelets or clotting factors,
  • InPx given plasma as replacement fluid:
  • allergic reactions
  • transfusion-related infections (hepatitis, HIV)
  • difficulty in gaining vascular access,
  • lesions can develop at venipuncture sites.
slide4

Human intravenous immune globulin (IVIG) Therapy

  • human IVIG, 0.4 gm/kg per day, for 5 days
  • effective in one patient with PGP after failure to respond to prednisone, dapsone, cyclosporine,and pulse methylprednisolonewhile therapy with cyclosporine and prednisone was continued.

* When used at the higher doses, IVIG possesses immunosuppressive activity through poorly understood mechanisms.

slide5

The principal disadvantages of this treatment

  • high cost
  • adverse effects(headache, chills, fever)
  • potential for transmissionof diseases with pooled sera.