Document Detail

Hemodynamic evaluation during plasma-exchange with intermittent flow.
MedLine Citation:
PMID:  6642744     Owner:  NLM     Status:  MEDLINE    
Plasma-exchange (PE) represents an effective therapeutic approach employed in several immunological nephropathies, poisonings and various other diseases. Hemodynamic changes during intermittent flow PE were studied--using the thermodilution technique--in 8 patients (3 male and 5 female) aged between 36 and 73 years (mean 46.4). The mean values for the following parameters were measured before, during every cycle--exchanging about 300 ml of fresh frozen plasma--and at the end of the session: mean arterial pressure (MAP), heart rate (HR), cardiac index (Cl), stroke index (SI), total peripheral resistence (TPR), central venous pressure (CVP), pulmonary arterial pressure (PAP) and pulmonary capillary wedge pressure (PCWP). During the first exchange the systemic circulation showed hemodynamic changes similar that of an acute hemorrhagic condition: decrease in MAP (from 106 to 97 mmHg), Cl (from 4.27 to 3.7 L/m'/m2), SI (from 53 to 49 ml/beat/m2) and CVP (from 6.9 to 4.4 mmHg); increase in TPR (from 1230 to 1339) dynes/sec/cm-5), while HR showed only mild changes. In the following cycles all the parameters progressively returned toward the previous values. During the first cycle the pulmonary circulation showed a decrease in PAP (from 15.5 to 13 mmHg) and PCWP (from 8.9 to 6.6 mmHg). PAP also increased constantly in the following cycles reaching at the end of the session levels which were higher than the initial ones. Our data demonstrate that in PE treatment especially when is employed a low volume of fluid, has to be substituted at every cycle in order to prevent the major hemodynamic complications i.e. hypovolemic shock and heart failure.
U Coli; S Landini; A Fracasso; P Morachiello; F Righetto; F Scanferla; G Bazzato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The International journal of artificial organs     Volume:  6 Suppl 1     ISSN:  0391-3988     ISO Abbreviation:  Int J Artif Organs     Publication Date:  1983 Jul 
Date Detail:
Created Date:  1984-01-07     Completed Date:  1984-01-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  91-4     Citation Subset:  IM    
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MeSH Terms
Blood Pressure
Centrifugation / methods
Middle Aged
Plasma Exchange / methods*
Pulmonary Circulation
Pulmonary Wedge Pressure
Vascular Resistance
Venous Pressure

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